Individual
ALEXIS KILLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4035 RANDOLPH ST, SAN DIEGO, CA 92103-1712
(626) 422-5006
Mailing address
4035 RANDOLPH ST, SAN DIEGO, CA 92103-1712
(626) 422-5006
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
22962
CA
Other
Enumeration date
01/10/2022
Last updated
01/10/2022
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