Most Relevant Information
Provider Data
| NPI Number: | 1003344003 |
| Provider Name: | CHARLENE KANTACK ANDERSON PHYSICAL THERAPIST |
| Entity Type: | Individual |
| Taxonomy Code: | 208100000X |
| Specialty: | Physical Medicine & Rehabilitation |
| License Number: | PT16045 |
Most Important Dates
| Enumeration Date: | 06/02/2017 |
| Last Updated: | 05/29/2024 |
Provider Practice Location
238 DICKENSON AVE
NEWBURY PARK
CA
913204326
Practice Location Phone/Fax
| Phone: | 8055515420 |
| Fax: |
Provider Mailing Location
238 DICKENSON AVE
NEWBURY PARK
CA
913204326
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |