Individual
FADI KAS-PETRUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1428 SUNNYLAND AVE, EL CAJON, CA 92019-2501
(248) 990-4738
Mailing address
1428 SUNNYLAND AVE, EL CAJON, CA 92019-2501
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
Y4909416
CA
Other
Enumeration date
05/03/2023
Last updated
05/03/2023
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