Individual
CAMILLE IVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1126 N GRAND AVE, COVINA, CA 91724-1551
(626) 967-1667
Mailing address
13722 ASPEN LEAF LN, CORONA, CA 92880-0720
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
07/30/2007
Last updated
07/30/2007
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