Individual
BROOKE TIRADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
845 S FAIRMONT AVE, LODI, CA 95240-3971
(209) 334-3411
Mailing address
509 W ELM ST, LODI, CA 95240-1911
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
302751
CA
Other
Enumeration date
11/14/2022
Last updated
11/14/2022
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