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Individual

WILLIAM DYKENS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA, CCS

Contact information

Practice address
2719 LOKER AVE W STE A, CARLSBAD, CA 92010-6679
(760) 918-9200
(760) 918-9203
Mailing address
1551 UNION ST UNIT 910, SAN DIEGO, CA 92101-3445
(858) 213-7558
(760) 918-9203

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
49110
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
49110
PHYSICAL THERAPY ASSISTANT
CA
Enumeration date
02/13/2018
Last updated
02/13/2018
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