NPI | 1952511610 |
---|---|
Other Name | FRED JOSEPH VALENZUELA |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT 3454) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 5002) |
225100000X Physical Therapist (Licence: UT 5896880-2401) | |
Enumeration Date | 2007-05-23 |
Last Update Date | 2007-07-08 |