Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
Dec 14, 2005
License(s)
PT 12917 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 12215 TELEGRAPH RD # 110 | Santa Fe Springs, CA 90670-3344 | 562-777-1333 |
| MAILING | 30112 CROWN VALLEY PKWY | Laguna Niguel, CA 92677-2042 | 949-363-7716 |
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