Individual
DORA HARVISTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 W CENTRAL AVE STE B, BREA, CA 92821-3036
(714) 529-5022
(714) 529-5016
Mailing address
9069 WALKER ST, CYPRESS, CA 90630-3161
(714) 322-8946
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
06/18/2018
Last updated
06/18/2018
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