Individual
BRIAN MICHELETTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3858 W CARSON ST STE 126, TORRANCE, CA 90503-6722
(424) 390-4010
Mailing address
3858 W CARSON ST STE 126, TORRANCE, CA 90503-6722
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251X0800X
Orthopedic Physical Therapist
PT23806
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT23806
PT LICENSE
CA
Enumeration date
03/30/2007
Last updated
03/03/2021
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