Cristina Maria Provasoli, PT
Physical Medicine & Rehabilitation in Playa Del Rey, CA. Individual provider (NPI-1).
NPI number1114554243
StatusActive
Last updated in NPPESMar 26, 2020
Details
- NPI
- 1114554243
- Entity type
- Individual (NPI-1)
- Name
- Cristina Maria Provasoli
- Credential
- PT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 26, 2020
- Certification date
- Mar 26, 2020
- Last updated
- Mar 26, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208100000X | Physical Medicine & Rehabilitation | 23872 | CA | Yes |
Practice location
8009 Hulbert AvePlaya Del Rey, CA 90293-7939
Phone 310-648-4045
Mailing address
8009 Hulbert AvePlaya Del Rey, CA 90293-7939
Phone 310-648-4045
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