JAMAL TYRONE LEDET-TRAVIS

SAN DIEGO, CA
NPI1194288118
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225400000X Rehabilitation Practitioner
Additional Taxonomies172V00000X Community Health Worker
Enumeration Date2019-04-08
Last Update Date2025-03-27
Business Address
JAMAL TYRONE LEDET-TRAVIS
1011 CAMINO DEL RIO S
SAN DIEGO, CA 92108-3531
Phone number: 619-287-8225
Mailing Address
JAMAL TYRONE LEDET-TRAVIS
4746 GUYMON ST REAR
SAN DIEGO, CA 92102-3730
Phone number: