Organization
PHOENIX MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT PRATLEY MD (ORTHOPEDIC)
(951) 687-6600
Entity
Organization
Contact information
Practice address
4355 E AIRPORT DR, SUITE 100, ONTARIO, CA 91761-7812
(909) 937-3400
(909) 937-3411
Mailing address
3576 ARLINGTON AVE, SUITE 100, RIVERSIDE, CA 92506-3943
(951) 687-6600
(951) 687-6601
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary
—
—
171100000X
Acupuncturist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Enumeration date
08/02/2013
Last updated
08/02/2013
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