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Individual

DR. CHARLESON PRINCE GODIO AGUSTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPT, CMT, CSCS

Contact information

Practice address
6000 GARDEN GROVE BLVD, WESTMINSTER, CA 92683-1976
(562) 270-1605
Mailing address
6000 GARDEN GROVE BLVD APT 238, WESTMINSTER, CA 92683-1955
(626) 756-5036

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
225700000X
Massage Therapist
79389
CA

Other

Enumeration date
05/31/2022
Last updated
09/07/2022
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