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MS. MOLLIE LOUISE BENNELL-LAZARUS MOLLIE BENNELL-LAZAR

>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1831302686

Individual Registrant:
MS. MOLLIE LOUISE BENNELL-LAZARUS MOLLIE BENNELL-LAZAR
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

Contact information for business:
2135 VIA TECA  SAN CLEMENTE, CA 92673-5649 US
Tel: 949-361-4726  Fax: 949-492-5608

Registration Information:
NPI: 1831302686
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
CAPT13340

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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