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General NPI Number Information
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NPI Number | 1033454285
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Entity Type | Individual
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Provider Name | JONATHAN FRANK AMANSEC PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 11/28/2012
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Last Update Date | 05/17/2018
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Provider Practice Location Address
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Address Line | 6425 MILES AVE
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255
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Country | US
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Telephone | 323-589-5941
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Fax |
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Provider Business Mailing Address
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Address Line | 18825 FAGAN AVE
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City | ARTESIA
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State | CA
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Zip | 90701-5803
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Country | US
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Telephone | 562-490-5555
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 38919
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License Number State | CA
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