Individual
JASON RICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4940 VAN NUYS BLVD STE 301, SHERMAN OAKS, CA 91403-1742
(818) 907-0952
(818) 990-9449
Mailing address
10851 MOORPARK ST APT 7, NORTH HOLLYWOOD, CA 91602-3924
(310) 924-0783
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
10527
CA
Other
Enumeration date
07/04/2018
Last updated
07/04/2018
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