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MS. MOLLIE LOUISE BENNELL-LAZARUS MOLLIE BENNELL-LAZAR
>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1831302686
Individual Registrant:MS. MOLLIE LOUISE BENNELL-LAZARUS MOLLIE BENNELL-LAZAR
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
3 PURSUIT ALISO VIEJO, CA 92656-4213 US
Tel: 949-389-8549 Fax: 949-362-9083
Tel: 949-389-8549 Fax: 949-362-9083
Contact information for business:
2135 VIA TECA SAN CLEMENTE, CA 92673-5649 US
Tel: 949-361-4726 Fax: 949-492-5608
Tel: 949-361-4726 Fax: 949-492-5608
Registration Information:
NPI: 1831302686
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapist | CA | PT13340 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
