Most Relevant Information
Provider Data
| NPI Number: | 1003066788 |
| Provider Name: | KRISTEN M MANECKE O.T. |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: | 2537 |
Most Important Dates
| Enumeration Date: | 09/30/2008 |
| Last Updated: | 02/03/2014 |
Provider Practice Location
4130 LA JOLLA VILLAGE DR
STE 103
LA JOLLA
CA
920379121
Practice Location Phone/Fax
| Phone: | 8584558584 |
| Fax: | 8584557302 |
Provider Mailing Location
4130 LA JOLLA VILLAGE DR
STE 103
LA JOLLA
CA
920379121
Provider Mailing Phone/Fax
| Phone: | 8584558584 |
| Fax: | 8584557302 |