Individual
MYRA KARINA VELAZCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
885 CANARIOS CT STE 110, CHULA VISTA, CA 91910-7877
(619) 656-5102
Mailing address
651 21ST ST APT B, SAN DIEGO, CA 92102-2816
(619) 804-6327
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
50987
CA
Other
Enumeration date
03/19/2024
Last updated
03/19/2024
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