Brooke Maggy, | |
10190 Culver Blvd, Culver City, CA 90232-3152 | |
(310) 837-9700 | |
Not Available |
Full Name | Brooke Maggy |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | 10190 Culver Blvd, Culver City, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1912771247 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 304574 (California) | Primary |
Provider Name | Optc Westside Inc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1942209242 PECOS PAC ID: 1355394214 Enrollment ID: O20050302001085 |
Mailing Address | Practice Location Address |
---|---|
Brooke Maggy, 10190 Culver Blvd, Culver City, CA 90232-3152 Ph: () - | Brooke Maggy, 10190 Culver Blvd, Culver City, CA 90232-3152 Ph: (310) 837-9700 |
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