Individual
BRYAN LEQUIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
47616 WILLOW POND RD, COARSEGOLD, CA 93614-9134
(949) 201-8946
Mailing address
47616 WILLOW POND RD, COARSEGOLD, CA 93614-9134
(949) 201-8946
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 26186
CA
Other
Enumeration date
01/05/2015
Last updated
01/05/2015
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