Individual
JASON WILLOUGHBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2236 MULBERRY LN, PLACERVILLE, CA 95667
(530) 391-6929
Mailing address
2236 MULBERRY LN, PLACERVILLE, CA 95667-7783
(530) 391-6929
Taxonomy
Speciality
Code
Description
License number
State
2472E0500X
EEG Technician
Primary
—
—
Other
Enumeration date
08/02/2013
Last updated
08/02/2013
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