CARISSA RAE VAN MIERLO

LAGUNA HILLS, CA
NPI1972269975
Former NameCARISSA RAE TENNEY
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
Enumeration Date2021-11-14
Last Update Date2021-11-14
Business Address
CARISSA RAE VAN MIERLO
23961 CALLE DE LA MAGDALENA STE 119
LAGUNA HILLS, CA 92653-3616
Phone number: 949-837-5111
Mailing Address
CARISSA RAE VAN MIERLO
2 DAYLILY
RANCHO SANTA MARGARITA, CA 92688-1442
Phone number: 949-290-1079