Individual
CHARLENE KANTACK ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
238 DICKENSON AVE, NEWBURY PARK, CA 91320-4326
(805) 551-5420
Mailing address
238 DICKENSON AVE, NEWBURY PARK, CA 91320-4326
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
PT16045
CA
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
06/02/2017
Last updated
05/29/2024
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