Provider Demographics
NPI:1144210972
Name:MUELLER - HANK, MARY (RPT)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:MUELLER - HANK
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27924 SECO CANYON RD
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-3870
Mailing Address - Country:US
Mailing Address - Phone:818-837-5785
Mailing Address - Fax:818-898-1842
Practice Address - Street 1:2315 KUEHNER DR
Practice Address - Street 2:SUITE 115
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-3900
Practice Address - Country:US
Practice Address - Phone:805-823-8200
Practice Address - Fax:805-823-8208
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT9899225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist