Individual
MADELAINE LOUISE SAN AGUSTIN SY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1420 S CENTRAL AVE, GLENDALE, CA 91204-2508
(818) 502-2330
Mailing address
824 ARCADIA AVE APT 2, ARCADIA, CA 91007-7223
(626) 346-6366
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
51797
CA
Other
Enumeration date
08/07/2023
Last updated
08/07/2023
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