Individual
ALIYAH GRACE PANGANIBAN DE LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
205 GRANADA ST, CAMARILLO, CA 93010-7715
(805) 482-9805
Mailing address
5776 DAMON ST, SIMI VALLEY, CA 93063-4229
(619) 635-8259
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
303358
CA
Other
Enumeration date
12/07/2022
Last updated
12/07/2022
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