Individual
JUSTIN WEATHERALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5739 CHESLEY AVE, LOS ANGELES, CA 90043-2423
(818) 826-1296
Mailing address
5739 CHESLEY AVE, LOS ANGELES, CA 90043-2423
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
06/03/2025
Last updated
06/03/2025
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