Individual
BRENTON MIKITO MICAH KANNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
292 RESERVATION RD, MARINA, CA 93933-3110
(831) 883-8542
Mailing address
201 GLENWOOD CIR APT 13E, MONTEREY, CA 93940-6723
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
300347
CA
Other
Enumeration date
06/24/2021
Last updated
06/29/2021
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