Individual
CHARMINADE MCCOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1060 PLAYGROUND RD, CRESTLINE, CA 92325
(573) 330-5261
Mailing address
PO BOX 2061, CRESTLINE, CA 92325-2061
(573) 330-5261
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT3151
CA
Other
Enumeration date
04/01/2016
Last updated
04/01/2016
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