Individual
JEIEL RAFFERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11140 RICHMONT RD, LOMA LINDA, CA 92354-2917
(541) 521-0930
Mailing address
11140 RICHMONT RD, LOMA LINDA, CA 92354-2917
(541) 521-0930
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
48081
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48081
CALIFORNIA PHYSICAL THERAPY BOARD
CA
Enumeration date
08/09/2016
Last updated
08/09/2016
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