Individual
JAIRO LENIN DUARTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
23007 GARZOTA DR, SANTA CLARITA, CA 91354-2230
(661) 877-0549
Mailing address
23007 GARZOTA DR, SANTA CLARITA, CA 91354-2230
(661) 877-0549
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
79431
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y4317983
EMERGENCY
CA
Enumeration date
02/24/2021
Last updated
02/24/2021
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