Individual
JASON MOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8327 BEVERLY DR, SAN GABRIEL, CA 91775-2403
(626) 283-0463
Mailing address
8327 BEVERLY DR, SAN GABRIEL, CA 91775-2403
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
10701
CA
Other
Enumeration date
07/22/2015
Last updated
07/22/2015
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