Individual
KELLY HIGGINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1031 AVENIDA PICO STE 201, SAN CLEMENTE, CA 92673-6356
(949) 288-8788
Mailing address
129 VIA SAN SEBASTIAN, SAN CLEMENTE, CA 92672-3890
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
CA
Other
Enumeration date
04/12/2024
Last updated
04/12/2024
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