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1881076719
GINA DERHAM
SAN DIEGO, CA
NPI
1881076719
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: CA AT 3602)
Enumeration Date
2015-06-27
Last Update Date
2015-06-27
Business Address
GINA DERHAM
12433 FLORESTA CT
SAN DIEGO, CA 92128-1310
Phone number: 858-485-8117
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Mailing Address
GINA DERHAM
12433 FLORESTA CT
SAN DIEGO, CA 92128-1310
Phone number: 858-485-8117
Copy
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