Individual
LUIS BRAVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2526 MAYBERRY ST, LOS ANGELES, CA 90026-2320
(213) 924-0243
Mailing address
2526 MAYBERRY ST, LOS ANGELES, CA 90026-2320
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
39713
CA
Other
Enumeration date
10/15/2020
Last updated
10/15/2020
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