Individual
PETTIE ONTELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16489 GALA AVE, FONTANA, CA 92337-1526
(323) 697-4357
Mailing address
16489 GALA AVE, FONTANA, CA 92337-1526
(323) 697-4357
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
50519
CA
Other
Enumeration date
09/26/2020
Last updated
09/26/2020
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