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Organization
RAVEN-L INC.
Active
Organization
RAVEN-L INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JEAN KEIKO RAVENELLE P.T. (CFO)
(626) 441-3124
Entity
Organization
Contact information
Practice address
1962 MILAN AVE, SOUTH PASADENA, CA 91030-4635
(626) 441-3124
(626) 441-3124
Mailing address
1962 MILAN AVE, SOUTH PASADENA, CA 91030-4635
(626) 441-3124
(626) 441-3124
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 14400
CA
225200000X
Physical Therapy Assistant
AT644
CA
Other
Enumeration date
08/15/2011
Last updated
08/15/2011
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