Individual
LENA CHARLENE BLACKSHEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
442 E HAMPTON ST, STOCKTON, CA 95204-5519
(209) 466-0456
Mailing address
5921 SILVEROAK CIR, STOCKTON, CA 95219-7187
(916) 216-3603
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA6329
CA
Other
Enumeration date
06/24/2020
Last updated
06/24/2020
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