Individual
MR. JOSE M. DE SAN JUAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.M.T.
Contact information
Practice address
1820 N AVON ST, BURBANK, CA 91505-1505
(818) 480-8148
Mailing address
1820 N AVON ST, BURBANK, CA 91505-1505
(818) 480-8148
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18450
CA
Other
Enumeration date
01/31/2011
Last updated
01/31/2011
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