Individual
JUAN CANTILLO CORREA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2019 W AVENUE K, LANCASTER, CA 93536-5217
(818) 990-9535
Mailing address
25115 AVENUE STANFORD STE B135, VALENCIA, CA 91355-1290
(661) 250-9940
(661) 250-9959
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
52134
CA
Other
Enumeration date
11/07/2022
Last updated
11/07/2022
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