Provider Demographics
NPI:1336426592
Name:HUOTT, MARLA L (PT)
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:L
Last Name:HUOTT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:11353 WOODCRAFT WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-2910
Mailing Address - Country:US
Mailing Address - Phone:619-589-2606
Mailing Address - Fax:619-464-0900
Practice Address - Street 1:5905 SEVERIN DR
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3806
Practice Address - Country:US
Practice Address - Phone:619-589-2606
Practice Address - Fax:619-464-0900
Is Sole Proprietor?:No
Enumeration Date:2011-11-15
Last Update Date:2012-03-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA38393225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFW402ZMedicare UPIN