Individual
BREANNA HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3865 JACKSON ST, RIVERSIDE, CA 92503-3919
(951) 688-2211
Mailing address
3865 JACKSON ST, RIVERSIDE, CA 92503-3919
(951) 688-2211
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
34068
CA
Other
Enumeration date
01/26/2012
Last updated
12/23/2021
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