Individual
MRS. CAROLINE L MAWANAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1167 PACIFIC GROVE LOOP, CHULA VISTA, CA 91915-2101
(619) 254-0683
Mailing address
1167 PACIFIC GROVE LOOP, CHULA VISTA, CA 91915-2101
(619) 254-0683
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
9174
CA
Other
Enumeration date
01/21/2013
Last updated
01/21/2013
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