Individual
JASON GOLLAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4019 BROTHERTON ST, CORONA, CA 92879-1814
(951) 850-7017
Mailing address
4019 BROTHERTON ST, CORONA, CA 92879-1814
(951) 850-7017
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
52372
CA
Other
Enumeration date
07/09/2025
Last updated
07/09/2025
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