Individual
PHILLIP LOKI EZPELETA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CMT
Contact information
Practice address
3935 32ND ST, #6, SAN DIEGO, CA 92104-2048
(619) 889-1831
Mailing address
3935 32ND ST, #6, SAN DIEGO, CA 92104-2048
(619) 889-1831
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18504
CA
Other
Enumeration date
12/05/2011
Last updated
12/05/2011
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