Individual
MARY MAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
9000 WAKARUSA ST BLDG A, LA MESA, CA 91942-3307
(619) 740-4600
Mailing address
2251 WORDEN ST APT 9, SAN DIEGO, CA 92107-1604
(619) 518-6301
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
21676
CA
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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