Individual
MELISSA TAMAYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1510 S MILLS AVE APT 209, LODI, CA 95242-4239
(209) 986-3585
Mailing address
1510 S MILLS AVE APT 209, LODI, CA 95242-4239
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4414
CA
Other
Enumeration date
08/25/2010
Last updated
08/25/2010
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