Individual
YEMISRACH KASAYE ERGAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5240 SEPULVEDA BLVD, CULVER CITY, CA 90230-5214
(310) 391-7266
Mailing address
4630 W MARTIN LUTHER KING JR BLVD APT 13, LOS ANGELES, CA 90016-5572
(559) 942-3976
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
49979
CA
Other
Enumeration date
05/14/2019
Last updated
05/14/2019
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