Individual
BRIAN KEITH RAGLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPT
Contact information
Practice address
9047 ARROW RTE, SUITE170, RANCHO CUCAMONGA, CA 91730-4449
(909) 466-8696
Mailing address
9047 ARROW RTE, SUITE170, RANCHO CUCAMONGA, CA 91730-4449
(909) 466-8696
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT36019
CA
Other
Enumeration date
11/07/2011
Last updated
11/07/2011
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