Most Relevant Information
Provider Data
| NPI Number: | 1003524224 |
| Provider Name: | JUAN CANTILLO CORREA PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | 52134 |
Most Important Dates
| Enumeration Date: | 11/07/2022 |
| Last Updated: | 11/07/2022 |
Provider Practice Location
2019 W AVENUE K
LANCASTER
CA
935365217
Practice Location Phone/Fax
| Phone: | 8189909535 |
| Fax: |
Provider Mailing Location
25115 AVENUE STANFORD STE B135
VALENCIA
CA
913551290
Provider Mailing Phone/Fax
| Phone: | 6612509940 |
| Fax: | 6612509959 |