Organization
GENESIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PEARL SOTELO (PTA)
(925) 360-3632
Entity
Organization
Contact information
Practice address
2098 HENDERSON WAY, LODI, CA 95242-4814
(925) 360-3632
Mailing address
2098 HENDERSON WAY, LODI, CA 95242-4814
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
8284
CA
Other
Enumeration date
06/20/2016
Last updated
06/20/2016
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