Organization
YOUR SPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANTOINETT M CASTRO 32539 (LICENSED MASSAGE THERAPIST)
(619) 255-0789
Entity
Organization
Contact information
Practice address
3609 4TH AVE, SAN DIEGO, CA 92103-4105
(619) 255-0789
Mailing address
3609 4TH AVE, SAN DIEGO, CA 92103-4105
(619) 255-0789
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
32539
CA
Other
Enumeration date
02/20/2017
Last updated
02/20/2017
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