GINA DERHAM

SAN DIEGO, CA
NPI1881076719
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: CA  AT 3602)
Enumeration Date2015-06-27
Last Update Date2015-06-27
Business Address
-- GINA DERHAM
12433 FLORESTA CT
SAN DIEGO, CA 92128-1310
Phone number: 858-485-8117
Mailing Address
-- GINA DERHAM
12433 FLORESTA CT
SAN DIEGO, CA 92128-1310
Phone number: 858-485-8117