Individual
JERRELL MINOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
510 W 26TH ST, MERCED, CA 95340-2804
(209) 723-2911
Mailing address
930 NEAL ST, LOS BANOS, CA 93635-5205
(209) 704-0711
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
50768
CA
Other
Enumeration date
02/13/2023
Last updated
02/13/2023
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