Mckenna Lise Anderson, MPT | |
6133 Bristol Pkwy, Suite 200, Culver City, CA 90230-6609 | |
(310) 337-7600 | |
Not Available |
Full Name | Mckenna Lise Anderson |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | 6133 Bristol Pkwy, Culver City, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1942508387 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | PT 37625 (California) | Primary |
Provider Name | Nrp Physical Therapy Corp. |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1477086643 PECOS PAC ID: 2163709544 Enrollment ID: O20170512001229 |
Mailing Address | Practice Location Address |
---|---|
Mckenna Lise Anderson, MPT 4908 Valley Ridge Ave, Los Angeles, CA 90043-1029 Ph: (323) 294-7671 | Mckenna Lise Anderson, MPT 6133 Bristol Pkwy, Suite 200, Culver City, CA 90230-6609 Ph: (310) 337-7600 |
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