Provider Demographics
NPI:1902121189
Name:GIRARD, DAVID B (PT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:B
Last Name:GIRARD
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:22913 1/2 SOLEDAD CANYON RD
Mailing Address - Street 2:DAVE AND DAVE REHAB SCIENCES
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-2997
Mailing Address - Country:US
Mailing Address - Phone:661-200-3677
Mailing Address - Fax:661-388-4496
Practice Address - Street 1:22913 1/2 SOLEDAD CANYON RD
Practice Address - Street 2:DAVE AND DAVE REHAB SCIENCES
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-2997
Practice Address - Country:US
Practice Address - Phone:661-200-3677
Practice Address - Fax:661-388-4496
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-31
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPT151572251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT15157OtherMEDICAL LICENSE