Individual
RAPHAEL GRENFELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
31685 ROUGE LN, MENIFEE, CA 92584-9258
(323) 743-5453
Mailing address
31685 ROUGE LN, MENIFEE, CA 92584
(323) 743-5453
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT9383
CA
Other
Enumeration date
09/03/2019
Last updated
09/03/2019
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