Individual
SHANE MICHAEL ENRIQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
31271 NIGUEL RD STE J, LAGUNA NIGUEL, CA 92677-4135
(949) 443-5442
(949) 443-5463
Mailing address
PO BOX 7840, LAGUNA NIGUEL, CA 92607-7840
(949) 443-5442
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
51442
CA
Other
Enumeration date
09/15/2021
Last updated
09/15/2021
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