Basic Information
| Provider Information | |||||||||
| NPI: | 1942455829 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HRONEK | ||||||||
| FirstName: | TERRI | ||||||||
| MiddleName: | LYN | ||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SCHULTZ | ||||||||
| OtherFirstName: | TERRI | ||||||||
| OtherMiddleName: | LYN | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 13939 VANOWEN ST APT 12 | ||||||||
| Address2: | |||||||||
| City: | VAN NUYS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 914054193 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8186242482 | ||||||||
| FaxNumber: | 8187813822 | ||||||||
| Practice Location | |||||||||
| Address1: | 14411 VANOWEN ST | ||||||||
| Address2: | |||||||||
| City: | VAN NUYS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 914054038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8189897475 | ||||||||
| FaxNumber: | 8187813822 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/19/2008 | ||||||||
| LastUpdateDate: | 11/19/2008 | ||||||||
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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 | 225400000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Practitioner |
No ID Information.