Individual
SHANDRA COENEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2480 IRVINE BLVD, 361, TUSTIN, CA 92782-8008
(714) 587-1674
Mailing address
2480 IRVINE BLVD, 361, TUSTIN, CA 92782-8008
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
10791
CA
Other
Enumeration date
11/26/2015
Last updated
11/26/2015
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