Individual
FERNANDO REY DUPA BOSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7016 CORVUS CIR, ROSEVILLE, CA 95747-8765
(916) 518-6300
Mailing address
7016 CORVUS CIR, ROSEVILLE, CA 95747-8765
(916) 518-6300
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA10893
CA
Other
Enumeration date
09/03/2020
Last updated
09/03/2020
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