Individual
CARRIE M HYMANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
11600 WILSHIRE BLVD, SUITE 222, LOS ANGELES, CA 90025-5781
(310) 477-8622
(310) 479-8238
Mailing address
11600 WILSHIRE BLVD, SUITE 222, LOS ANGELES, CA 90025-5781
(310) 477-8622
(310) 479-8238
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT7543
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1255489332
ORGANIZATION NPI
CA
01
—
ZZZ21430Z
BLUE SHIELD PROVIDER#
CA
Enumeration date
03/01/2007
Last updated
07/08/2007
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