Jethro Payne De Vega La Rosa
Jethro Payne De Vega La Rosa is a Physical Therapy Assistant in Fremont, California. Licensed in California. Registered with an NPI since 2013.
- Licensed in
- CA
- In the registry since
- 2013
Practice location Address checks out
39210 State St Ste 202Fremont, CA 94538-1456
Phone: (510) 790-9480
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physical Therapy Assistant (primary) | Taxonomy 225200000X (CA) |
|---|
Record details
| NPI number | 1720422983 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | April 18, 2013 |
| Last updated in NPPES | April 18, 2013 |
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