Individual
HEATHER LEA LACQUEMENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
16271 BEACH BLVD, HUNTINGTON BEACH, CA 92647-4102
(714) 375-1755
(714) 375-1757
Mailing address
16271 BEACH BLVD, HUNTINGTON BEACH, CA 92647-4102
(714) 375-1755
(714) 375-1757
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
8788
CA
Other
Enumeration date
10/22/2009
Last updated
10/22/2009
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