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1336892447
LYDIA JANE FORTNER
FRESNO, CA
NPI
1336892447
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: CA 51213)
Enumeration Date
2022-01-28
Last Update Date
2022-01-28
Business Address
LYDIA JANE FORTNER PTA
1649 VAN NESS AVE
FRESNO, CA 93721-1128
Phone number: 559-777-6722
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Mailing Address
LYDIA JANE FORTNER PTA
6358 N BENEDICT AVE
FRESNO, CA 93711-1605
Phone number: 559-906-1494
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