Individual
GREGORY PATRICK MAGLAQUI VERA CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1700 E BULLARD AVE STE 102, FRESNO, CA 93710-5866
(559) 438-8531
(559) 438-8307
Mailing address
2821 E SPRUCE AVE, FRESNO, CA 93720-0379
(310) 279-6832
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
50006
CA
Other
Enumeration date
06/03/2019
Last updated
06/03/2019
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