Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
Aug 16, 2013
License(s)
296718 (CA), PT 3481 (AR)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 9601 INTERSTATE 630 EXIT 7 | Little Rock, AR 72205-7202 | |
| LOCATION | 2700 DOLBEER ST | Eureka, CA 95501-4736 | 707-445-8121 |
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