Individual
MRS. MADONNA DIZON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
836 FISCHER ST APT B, GLENDALE, CA 91205-3888
(818) 274-4504
Mailing address
836 FISCHER ST APT B, GLENDALE, CA 91205-3888
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
10614
CA
Other
Enumeration date
01/28/2016
Last updated
01/28/2016
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