Individual
ALEXIS MICLAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18856 AMAR RD STE 8, WALNUT, CA 91789-7102
(626) 667-8600
Mailing address
1151 N NEW HAMPSHIRE AVE, LOS ANGELES, CA 90029-1707
(213) 298-6806
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
49306
CA
Other
Enumeration date
05/14/2018
Last updated
05/14/2018
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