Individual
JAN VONBREITENBAUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1500 N LAKELINE BLVD, CEDAR PARK, TX 78613-6788
(210) 929-9041
Mailing address
1301 MAX COPELAND DR APT 621, MARBLE FALLS, TX 78654-2076
(210) 929-9041
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2012258
TX
Other
Enumeration date
06/28/2022
Last updated
06/28/2022
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