Individual
THERESA FRASSRAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1904 RICHLAND AVE, CERES, CA 95307-4562
(209) 541-2121
Mailing address
1904 RICHLAND AVE, CERES, CA 95307-4562
(209) 541-2121
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
R1233880716
CA
Other
Enumeration date
09/13/2016
Last updated
09/13/2016
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