NPI 1003524224

Juan Cantillo Correa, PTA

Practitioner Physical Therapy Assistant Lancaster, CA

Practice location

Address: 2019 W Avenue K, Lancaster, CA 93536-5217
Phone: (818) 990-9535
Mailing address: 25115 Avenue Stanford STE B135, Valencia, CA 91355-1290

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 52134 (CA)

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Registry record

NPI: 1003524224
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Nov 2022
Record last updated: 7 Nov 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.