LEANDRO MODENESE BASTOS

LAKE ELSINORE, CA
NPI1679045546
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: CA  296037)
Enumeration Date2018-12-17
Last Update Date2019-07-25
Business Address
LEANDRO MODENESE BASTOS PT DPT
425 DIAMOND DR STE 101
LAKE ELSINORE, CA 92530-4495
Phone number: 951-674-9515
Mailing Address
LEANDRO MODENESE BASTOS PT DPT
1060 VALE TERRACE DR APT 8
VISTA, CA 92084-5228
Phone number: 562-212-8477