Individual
MARISSA WAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
11420 WARNER AVE, FOUNTAIN VALLEY, CA 92708-2529
(657) 204-2959
Mailing address
4201 VIA MARINA APT 305, MARINA DEL REY, CA 90292-4502
(570) 878-5273
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
52029
CA
Other
Enumeration date
05/01/2023
Last updated
05/01/2023
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