Staci A. Self, P.T.

NPI #1437458411 in San Clemente, California

Provider Information

NPI Number: 1437458411
Entity Type: Individual
Name: Staci A. Self, P.T.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: P.T.
Enumeration Date: Mar 16, 2011
Last Updated: Mar 16, 2011

Practice Location

Address: 653 CAMINO DE LOS MARES STE 110
City: San Clemente
State: California
ZIP Code: 92673-2808
Phone: (949) 496-0122

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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