Individual
MRS. JEANNETTE DILEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
800 S HAM LN, LODI, CA 95242-3543
(209) 368-7141
Mailing address
2904 WHITE OAK WAY, LODI, CA 95242-2034
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT6474
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT6474
PHYSICAL THERAPY BOARD OF CALIFORNIA
CA
Enumeration date
08/05/2017
Last updated
08/05/2017
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