NPI 1508284886

Jodelyn Teofila Ettlin, PTA

Practitioner Physical Therapy Assistant Rohnert Park, CA

Practice location

Address: 6174 State Farm Dr, Rohnert Park, CA 94928-2135
Phone: (707) 480-7789
Mailing address: 1244 de Meo St, Santa Rosa, CA 95407-5924

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence AT-9120 (CA)

Other Physical Therapy Assistant providers in California →

Registry record

NPI: 1508284886
Entity type: Individual
Sex (as registered): Female
NPI issued: 3 Apr 2014
Record last updated: 3 Apr 2014

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.