Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
May 28, 2013
License(s)
PT 40173 (CA), 40173 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 1392 W 7TH ST | Upland, CA 91786-7070 | 909-256-3762 |
| LOCATION | 1392 W 7TH ST | Upland, CA 91786-7070 | 909-256-3762 |
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