Individual
CHANNELL NICOLE ENRIQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1725 BLOSSOM CREST ST, BAKERSFIELD, CA 93314-9285
(805) 814-4392
Mailing address
1725 BLOSSOM CREST ST, BAKERSFIELD, CA 93314-9285
(805) 814-4392
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
48391
CA
Other
Enumeration date
08/19/2021
Last updated
08/19/2021
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