Provider Demographics
NPI:1740371202
Name:FURMAN, MICHELLE LYNNE (MS, PT)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LYNNE
Last Name:FURMAN
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12105 ELEONORE CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-3807
Mailing Address - Country:US
Mailing Address - Phone:858-653-3929
Mailing Address - Fax:
Practice Address - Street 1:12105 ELEONORE CT
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-3807
Practice Address - Country:US
Practice Address - Phone:858-653-3929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist