Individual
MR. JESSE BARRETTO MAICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6080 CENTER DR FL 6, LOS ANGELES, CA 90045-9205
(888) 859-0145
Mailing address
PO BOX 1295, VENICE, CA 90294-1295
(888) 590-1458
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA49304
CA
Other
Enumeration date
07/02/2018
Last updated
12/06/2022
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