Individual
JOHNATHAN BRANDON WELLINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
25400 ALESSANDRO BLVD STE 102, MORENO VALLEY, CA 92553-4319
(951) 750-0117
Mailing address
27882 DE LA VALLE DR, MORENO VALLEY, CA 92555-5917
(951) 750-0117
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
550006383
CA
Other
Enumeration date
09/05/2021
Last updated
09/05/2021
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