| Luis Ponce, | |
|
1610 Santa Clara St Apt 3, Santa Clara, CA 95050-5367 | |
| (408) 707-2884 | |
| Not Available |
| Full Name | Luis Ponce |
|---|---|
| Gender | Male |
| Speciality | Massage Therapist |
| Location | 1610 Santa Clara St Apt 3, Santa Clara, California |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386472140 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225700000X | Massage Therapist | 137435 (California) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Luis Ponce, 1610 Santa Clara St Apt 3, Santa Clara, CA 95050-5367 Ph: Not Available | Luis Ponce, 1610 Santa Clara St Apt 3, Santa Clara, CA 95050-5367 Ph: (408) 707-2884 |
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