Individual
GREGORY VAYSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5310 FOUNTAIN AVE, LOS ANGELES, CA 90029-1005
(215) 917-0696
Mailing address
110 S SWEETZER AVE APT 401, LOS ANGELES, CA 90048-3589
(215) 917-0696
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
14204
CA
Other
Enumeration date
01/14/2015
Last updated
01/14/2015
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