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Organization
PRIME REHAB CENTER PHYSICAL THERAPY A PROFESSIONAL CORPORATION
Active
Organization
PRIME REHAB CENTER PHYSICAL THERAPY A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIA CUEVAS ADAME (OFFICE MANAGER)
(909) 365-3557
Entity
Organization
Contact information
Practice address
8545 SIERRA AVE, FONTANA, CA 92335-3868
(909) 365-3557
(909) 658-8987
Mailing address
8545 SIERRA AVE, FONTANA, CA 92335-3868
(909) 365-3557
(909) 658-8987
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT35680
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT35680
CALIFORNIA PHYSICAL THERAPY BOARD
CA
Enumeration date
11/11/2016
Last updated
09/10/2020
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