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Individual

THERESA ROSE PEROVICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
18111 NORDHOFF ST, NORTHRIDGE, CA 91330-0001
(440) 749-3783
Mailing address
18321 MALDEN ST APT 4, NORTHRIDGE, CA 91325-3627
(440) 749-3783

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
06/09/2020
Last updated
06/09/2020
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