Individual
LYDIA JANE FORTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1649 VAN NESS AVE, FRESNO, CA 93721-1128
(559) 777-6722
Mailing address
6358 N BENEDICT AVE, FRESNO, CA 93711-1605
(559) 906-1494
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
51213
CA
Other
Enumeration date
01/28/2022
Last updated
01/28/2022
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