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1023223443
WALTER TABLANTE DE JESUS
FONTANA, CA
NPI
1023223443
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: CA PT24337)
Enumeration Date
2007-05-10
Last Update Date
2007-07-08
Business Address
-- WALTER TABLANTE DE JESUS RPT
13578 HATCHER PL
FONTANA, CA 92336-2945
Phone number: 909-641-1096
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Mailing Address
-- WALTER TABLANTE DE JESUS RPT
13578 HATCHER PL
FONTANA, CA 92336-2945
Phone number: 909-641-1096
Copy
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