Individual
SANDY MARIE PUFKYNEGUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2107 E. DEL AMO BL, RANCHO DOMINGUEZ, CA 90220
(310) 637-9611
Mailing address
937 CABRILLO DR, DUARTE, CA 91010
(626) 358-0997
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT 1765
CA
Other
Enumeration date
10/20/2006
Last updated
07/08/2007
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