Basic Information
| Provider Information | |||||||||
| NPI: | 1033229489 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARTSEL | ||||||||
| FirstName: | CYNTHIA | ||||||||
| MiddleName: | |||||||||
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| Credential: | PT, PHD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | HODGSON | ||||||||
| OtherFirstName: | CYNTHIA | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 870 | ||||||||
| Address2: | |||||||||
| City: | MURRIETA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925640870 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9513033566 | ||||||||
| FaxNumber: | 9513033577 | ||||||||
| Practice Location | |||||||||
| Address1: | 31720 US HIGHWAY 79 S | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | TEMECULA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925925895 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9513033566 | ||||||||
| FaxNumber: | 9513033577 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT33064 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.