Jesse Kusmulyana, PTA Valid NPI

Individual provider · Physical Therapy Assistant · Peridot, AZ

NPI

1467010082

Type

Individual (Type 1)

Primary specialty

Physical Therapy Assistant

Specialty group

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy code

225200000X

License number

PTA-013887 (AZ)

Sex

Male

Sole proprietor

No

Enumerated

2019-05-29

Last updated

2019-05-29