Individual
ATHENS RANDOLF ALCONCEL SALVADOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2705 TEMESCAL DR, MODESTO, CA 95355-8612
(209) 549-6365
Mailing address
2705 TEMESCAL DR, MODESTO, CA 95355-8612
(209) 549-6365
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
34599
CA
Other
Enumeration date
08/14/2010
Last updated
02/11/2022
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