Individual
GERALD TERRELL PONDER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D
Contact information
Practice address
151 ARMSTRONG WAY, APT B, UPLAND, CA 91786-6335
(909) 354-6110
Mailing address
151 ARMSTRONG WAY, APT B, UPLAND, CA 91786-6335
(909) 354-6110
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
D9514099
CA
Other
Enumeration date
02/23/2011
Last updated
02/23/2011
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