Individual
CAROLYN MICLEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
866 CAMPUS DR, STANFORD, CA 94305-8508
(650) 723-3195
(650) 723-8035
Mailing address
2145 THE ALAMEDA, SAN JOSE, CA 95126-1141
(408) 248-6886
(408) 248-4923
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT15145
CA
Other
Enumeration date
11/19/2015
Last updated
11/19/2015
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