Individual
XANDEE LU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
630 W BROADWAY, GLENDALE, CA 91204-1008
(818) 247-3395
Mailing address
138 S ADAMS ST APT 5, GLENDALE, CA 91205-1378
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
10306
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10306
PTA
CA
Enumeration date
07/15/2020
Last updated
07/21/2020
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