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Individual
JOANNA F EHRENBORG
Active
Individual
JOANNA F EHRENBORG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
17864
MA
225100000X
Physical Therapist
Primary
43617
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110085285A
—
MA
01
—
OPT436172
BLUE SHIELD
CA
Enumeration date
11/19/2008
Last updated
07/21/2022
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