Individual
TIMOTHY JAMES LACERNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
247 E BOBIER DR, VISTA, CA 92084-3026
(760) 945-3033
Mailing address
250 KNOLL RD APT 35, SAN MARCOS, CA 92069-1576
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA50180
CA
Other
Enumeration date
12/05/2019
Last updated
12/09/2019
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