Individual
CHARLENE POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
805 AEROVISTA PL STE 104, SAN LUIS OBISPO, CA 93401-7921
(805) 543-7771
(805) 543-7761
Mailing address
1106 WALNUT ST, SUITE 110, SAN LUIS OBISPO, CA 93401-2416
(805) 788-0805
(805) 788-0845
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT292784
CA
Other
Enumeration date
02/08/2017
Last updated
02/08/2017
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