Individual
MARY CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3023 BUNKER HILL ST, #201, SAN DIEGO, CA 92109-5706
(619) 977-6491
Mailing address
3023 BUNKER HILL ST, #201, SAN DIEGO, CA 92109-5706
(619) 977-6491
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
5790
CA
Other
Enumeration date
07/05/2011
Last updated
07/05/2011
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