Provider Demographics
NPI:1770782088
Name:VECHIK, MARGARET ANNE (PT)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:ANNE
Last Name:VECHIK
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 1:2460 WOOD CT
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-1938
Mailing Address - Country:US
Mailing Address - Phone:909-482-0511
Mailing Address - Fax:
Practice Address - Street 1:1740 S SAN DIMAS AVE
Practice Address - Street 2:
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-5108
Practice Address - Country:US
Practice Address - Phone:909-394-0304
Practice Address - Fax:909-305-4613
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 10205225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist