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1609097518
EDWARD THOMAS JELLEN
STOCKTON, CA
NPI
1609097518
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: CA PT 22111)
Enumeration Date
2007-05-01
Last Update Date
2007-07-08
Business Address
Mr. EDWARD THOMAS JELLEN PT
2357 W. MARCH LANE
STOCKTON, CA 95207
Phone number: 209-951-6037
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Mailing Address
Mr. EDWARD THOMAS JELLEN PT
3326 MOUNT REBA CT
STOCKTON, CA 95212-3105
Phone number: 209-952-0296
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