Individual
CARLA PRYOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3809 PLAZA DR, STE 112, OCEANSIDE, CA 92056-4625
(760) 941-2630
Mailing address
6221 METROPOLITAN ST, UNIT 101, CARLSBAD, CA 92009-3096
(760) 707-5080
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT36873
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT36873
PT LICENSE
CA
Enumeration date
07/27/2010
Last updated
07/27/2010
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