THEDDY TRECE GERONIMO GRUMO

FRESNO, CA
NPI1104452267
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: CA  50168)
Enumeration Date2020-03-19
Last Update Date2020-03-19
Business Address
Mr. THEDDY TRECE GERONIMO GRUMO PTA
5555 N FRESNO ST
FRESNO, CA 93710-6006
Phone number: 559-430-8211
Mailing Address
Mr. THEDDY TRECE GERONIMO GRUMO PTA
4560 SE INTERNATIONAL WAY STE 100
MILWAUKIE, OR 97222-4628
Phone number: