Individual
IIA POLIULIAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12099 W WASHINGTON BLVD STE 408, LOS ANGELES, CA 90066-2620
(424) 228-4340
Mailing address
415 MONTEREY LN APT B1, SAN CLEMENTE, CA 92672-7607
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
08/26/2019
Last updated
08/26/2019
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