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Organization
WIMBLEDON PARK PHYSICAL THERAPY
Active
Organization
WIMBLEDON PARK PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY HOPPER PT (MANAGER)
(760) 951-9702
Entity
Organization
Contact information
Practice address
12611 HESPERIA RD, STE B, VICTORVILLE, CA 92395-7720
(760) 951-9702
(760) 951-8594
Mailing address
12611 HESPERIA RD, STE B, VICTORVILLE, CA 92395-7720
(760) 951-9702
(760) 951-8594
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT13643
CA
Other
Enumeration date
06/13/2006
Last updated
08/13/2007
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