Individual
MARY JOY CODILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
260 E MARKET ST, LONG BEACH, CA 90805-5910
(562) 428-4681
Mailing address
260 E MARKET ST, LONG BEACH, CA 90805-5910
(562) 428-4681
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT8112
CA
Other
Enumeration date
12/23/2014
Last updated
06/17/2016
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