Individual
JENNIFER LYNN LINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1269 PALMER AVE, CAMARILLO, CA 93010-3342
(650) 450-3809
Mailing address
1269 PALMER AVE, CAMARILLO, CA 93010-3342
(650) 450-3809
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PT6515
CA
Other
Enumeration date
02/27/2019
Last updated
02/27/2019
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