SHANE VIDAL

NORTHRIDGE, CA
NPI1831903905
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: CA  53866)
Enumeration Date2025-02-06
Last Update Date2025-02-06
Business Address
SHANE VIDAL
11260 WILBUR AVE STE 101
NORTHRIDGE, CA 91326-2450
Phone number: 818-832-5656
Mailing Address
SHANE VIDAL
22003 LIGGETT ST
CHATSWORTH, CA 91311-5721
Phone number: 818-534-6199
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