Individual
MARIAN CUSTODIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
720 LACROSSE PL, ESCONDIDO, CA 92025-6358
(619) 888-1832
(619) 231-7040
Mailing address
720 LACROSSE PL, ESCONDIDO, CA 92025-6358
(619) 888-1832
(619) 231-7040
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
9474
CA
Other
Enumeration date
01/07/2015
Last updated
01/07/2015
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