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Organization
OUR LADY OF PROVIDENCE PT CLINIC
Active
Organization
OUR LADY OF PROVIDENCE PT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MARCELLE DEAIBES RPT (REGISTERED PHYSICAL THERAPIST)
(818) 506-4119
Entity
Organization
Contact information
Practice address
10843 MAGNOLIA BLVD, SUITE 2, NORTH HOLLYWOOD, CA 91601
(818) 506-4119
(818) 506-8115
Mailing address
10843 MAGNOLIA BLVD, SUITE 2, NORTH HOLLYWOOD, CA 91601
(818) 506-4119
(818) 506-8115
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 18580
CA
Other
Enumeration date
05/02/2007
Last updated
08/22/2020
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