Provider Demographics
NPI:1821175837
Name:GEARY, ROXANE (DC, PTA)
Entity Type:Individual
Prefix:MS
First Name:ROXANE
Middle Name:
Last Name:GEARY
Suffix:
Gender:F
Credentials:DC, PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-1904
Mailing Address - Country:US
Mailing Address - Phone:818-340-8320
Mailing Address - Fax:
Practice Address - Street 1:7301 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 102
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1904
Practice Address - Country:US
Practice Address - Phone:818-340-8320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC19126111NX0800X
CAAT3425225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111NX0800XChiropractic ProvidersChiropractorOrthopedic
Not Answered225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant