Organization
CELL STAFF
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON TA (PHYSICAL THERAPY ASSISTANT)
(408) 821-6101
Entity
Organization
Contact information
Practice address
2811 W CALIFORNIA AVE, FRESNO, CA 93706-2306
(559) 493-4400
Mailing address
2447 CARSON AVE, CLOVIS, CA 93611-6548
(408) 821-6101
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
AT11188
CA
Other
Enumeration date
01/05/2016
Last updated
01/05/2016
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