Individual
MR. JUDE N TEMPLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA, ATC
Contact information
Practice address
6100 STONEHOUSE RD, SLOUGHHOUSE, CA 95683-9616
(707) 834-1744
Mailing address
PO BOX 1161, SLOUGHHOUSE, CA 95683-1161
(707) 834-1744
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
48217
CA
2255A2300X
Athletic Trainer
0815
AZ
2255A2300X
Athletic Trainer
—
CA
Other
Enumeration date
05/02/2009
Last updated
09/15/2016
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