Individual
MISS JENNIFER LEIGH BANCALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2851 S AVENUE B STE 2402, YUMA, AZ 85364-7726
(800) 391-9477
Mailing address
2851 S AVENUE B STE 2402, YUMA, AZ 85364-7726
(800) 391-9477
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT 8720
CA
Other
Enumeration date
12/14/2013
Last updated
12/14/2013
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