Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
Apr 14, 2026
License(s)
306559 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 761 W BAGNALL ST | Glendora, CA 91740-4111 | |
| LOCATION | 1812 VERDUGO BLVD | Glendale, CA 91208-1407 | 818-790-7100 |
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