Individual
MAHTA GAZOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
72201 COUNTRY CLUB DR, RANCHO MIRAGE, CA 92270-4001
(760) 340-5999
Mailing address
72201 COUNTRY CLUB DR, RANCHO MIRAGE, CA 92270-4001
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT 8694
CA
Other
Enumeration date
07/14/2009
Last updated
09/18/2009
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