Individual
IA VANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
577 S PEACH AVE, FRESNO, CA 93727-3952
(559) 251-8463
Mailing address
159 N SHELLY AVE, FRESNO, CA 93727-3651
(720) 471-3090
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
53324
CA
Other
Enumeration date
09/06/2024
Last updated
09/06/2024
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