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Individual

KATRIN MATTERN-BAXTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1460 DREW AVE STE 200, DAVIS, CA 95618-4856
(530) 753-9011
Mailing address
1460 DREW AVE STE 200, DAVIS, CA 95618-4856

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT16894
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1770675639
PHYSICAL EDGE, INC.
CA
Enumeration date
01/21/2009
Last updated
03/13/2009
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