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JODELYN TEOFILA ETTLIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
6174 STATE FARM DR, ROHNERT PARK, CA 94928-2135
(707) 480-7789
Mailing address
1244 DE MEO ST, SANTA ROSA, CA 95407-5924
(707) 480-7789

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT-9120
CA

Other

Enumeration date
04/03/2014
Last updated
04/03/2014
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