Basic Information
| Provider Information | |||||||||
| NPI: | 1144210972 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MUELLER - HANK | ||||||||
| FirstName: | MARY | ||||||||
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| Credential: | R.P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 27924 SECO CANYON RD | ||||||||
| Address2: | |||||||||
| City: | SANTA CLARITA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913503870 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188375785 | ||||||||
| FaxNumber: | 8188981842 | ||||||||
| Practice Location | |||||||||
| Address1: | 2315 KUEHNER DR | ||||||||
| Address2: | SUITE 115 | ||||||||
| City: | SIMI VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930633900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8058238200 | ||||||||
| FaxNumber: | 8058238208 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2005 | ||||||||
| LastUpdateDate: | 07/10/2009 | ||||||||
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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 | PT9899 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.