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1861004459
JARED AMGOTT-KWAN
OAKLAND, CA
NPI
1861004459
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: CA 50719)
Enumeration Date
2020-08-17
Last Update Date
2020-08-17
Business Address
JARED AMGOTT-KWAN PTA
6116 MEDAU PL
OAKLAND, CA 94611-2809
Phone number: 510-339-2116
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Mailing Address
JARED AMGOTT-KWAN PTA
176 ATHOL AVE APT 1
OAKLAND, CA 94606-1737
Phone number:
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