Individual
PRAVEEN KUMAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2724 ACAPULCO WAY, MODESTO, CA 95355-8733
(209) 722-8208
Mailing address
2724 ACAPULCO WAY, MODESTO, CA 95355-8733
(209) 722-8208
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT 8650
CA
Other
Enumeration date
11/26/2012
Last updated
11/26/2012
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