Individual
JORDAN MATTHEW DELAGRANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2801 CAMINO DEL RIO S STE 204-7, SAN DIEGO, CA 92108-3800
(260) 444-1159
Mailing address
2606 RIDGEWAY DR APT 3203, NATIONAL CITY, CA 91950-7772
(260) 444-1159
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
83253
CA
Other
Enumeration date
09/30/2021
Last updated
09/30/2021
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