KENNETH MARK NIEDO CRUZ

GLENDALE, CA
NPI1184219891
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: CA  49797)
Enumeration Date2021-03-04
Last Update Date2021-03-04
Business Address
KENNETH MARK NIEDO CRUZ PTA
1000 N CENTRAL AVE STE 110
GLENDALE, CA 91202-3685
Phone number: 818-243-8422
Mailing Address
KENNETH MARK NIEDO CRUZ PTA
808 E WINDSOR RD APT 9
GLENDALE, CA 91205-2441
Phone number: 323-384-8912