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Individual

THI LE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
4647 ZION AVE, SAN DIEGO, CA 92120-2507
(619) 528-5000
Mailing address
3755 CLINIC RD, BELOIT, WI 53511-1900

Taxonomy

Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
11948-24
WI
282N00000X
General Acute Care Hospital
Primary
39430
CA

Other

Enumeration date
08/21/2012
Last updated
10/11/2021
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