Michelle Derouso, PTA
NPI #1134893316 in Lake Forest, California
Provider Information
- NPI Number
- 1134893316
- Entity Type
- Individual
- Name
- Michelle Derouso, PTA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physical Therapy Assistant
- Credential
- PTA
- Enumeration Date
- Aug 2, 2021
- Last Updated
- Aug 2, 2021
Practice Location
- Address
- 26342 FOREST RIDGE DR UNIT 5C
- City
- Lake Forest
- State
- California
- ZIP Code
- 92630-7820
- Phone
- (714) 943-3709
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapy Assistant |
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