Individual
ASHLEY PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16300 ROSCOE BLVD, SUITE 1A, VAN NUYS, CA 91406
(833) 893-4426
Mailing address
11862 SAINT MARK ST, GARDEN GROVE, CA 92845-1108
(714) 891-0548
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
10/19/2022
Last updated
09/29/2024
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