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MAILE BAY JAQUES PT

>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1609107911

Individual Registrant:
 MAILE  BAY JAQUES PT
Gender: F
Not Sole Proprietor

Location and contact information for practice:
28631 S WESTERN AVE SUITE 104A RANCHO PALOS VERDES, CA 90275 US
Tel: 310-548-5444  Fax: 310-548-8444

Contact information for business:
PO BOX 6384  SAN PEDRO, CA 90734-6384 US
Tel: 310-548-5444  Fax: 310-548-8444

Registration Information:
NPI: 1609107911
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
CA
N225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
CAPT35890

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
PHYSICAL THERAPISTPT35890CA01




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