Individual
NICHOLAS BACKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4959 PALO VERDE ST STE 109C, MONTCLAIR, CA 91763-2358
(909) 971-3092
Mailing address
4959 PALO VERDE ST STE 109C, MONTCLAIR, CA 91763-2358
(909) 971-3092
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
52023
CA
Other
Enumeration date
02/24/2025
Last updated
02/24/2025
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