Individual
JASON FRANK WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BOCO BOCP
Contact information
Practice address
8143 GANDY DANCER WAY, SACRAMENTO, CA 95823-5928
(916) 752-8905
Mailing address
8143 GANDY DANCER WAY, SACRAMENTO, CA 95823-5928
(916) 752-8905
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
C50840
—
224P00000X
Prosthetist
Primary
C50840
—
Other
Enumeration date
10/10/2018
Last updated
10/10/2018
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