Provider Demographics
NPI:1770833923
Name:MUNN, HEDWIG H (PT)
Entity Type:Individual
Prefix:MRS
First Name:HEDWIG
Middle Name:H
Last Name:MUNN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1891
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92038
Mailing Address - Country:US
Mailing Address - Phone:561-531-4240
Mailing Address - Fax:
Practice Address - Street 1:7623 EADS AVE.
Practice Address - Street 2:1A
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92038
Practice Address - Country:US
Practice Address - Phone:561-531-4240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19815225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist