Individual
MS. COLEEN KAY MAYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
17456 BEACH BLVD STE 102, HUNTINGTON BEACH, CA 92647-5913
(714) 841-2688
Mailing address
9381 FIRESIDE DR, HUNTINGTON BEACH, CA 92646-5903
(714) 963-7965
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT6708
CA
Other
Enumeration date
03/24/2007
Last updated
07/08/2007
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