GENEFREY GANTIOQUI

BUENA PARK, CA
NPI1104407147
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: CA  10152)
Enumeration Date2021-04-20
Last Update Date2021-04-20
Business Address
GENEFREY GANTIOQUI
8219 VALLEY VIEW ST
BUENA PARK, CA 90620-2700
Phone number: 562-612-6943
Mailing Address
GENEFREY GANTIOQUI
8219 VALLEY VIEW ST
BUENA PARK, CA 90620-2700
Phone number: 562-612-6943
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