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Individual

LISA MARIE HARDIMON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPT

Contact information

Practice address
2621 MANHATTAN BEACH BLVD, REDONDO BEACH, CA 90278-1604
(310) 374-0477
(310) 374-1605
Mailing address
2621 MANHATTAN BEACH BLVD, REDONDO BEACH, CA 90278-1604
(310) 374-0477
(310) 374-1605

Taxonomy

Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
PT19902
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PT19902
PT LICENSE
CA
Enumeration date
10/15/2012
Last updated
06/06/2024
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