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Individual

DENNIS JARDIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA, ATC

Contact information

Practice address
5810 EL CAMINO REAL, SUITE A, CARLSBAD, CA 92008-8819
(760) 929-8269
Mailing address
5810 EL CAMINO REAL, SUITE A, CARLSBAD, CA 92008-8819
(760) 929-8269

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT 6630
CA
2255A2300X
Athletic Trainer
119702546
CA

Other

Enumeration date
11/05/2009
Last updated
11/05/2009
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