Individual
MRS. KELLEY MARIE BOYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
8655 HAVEN AVE STE 200, RANCHO CUCAMONGA, CA 91730-4891
(800) 642-5031
(909) 989-7633
Mailing address
PO BOX 1565, RANCHO CUCAMONGA, CA 91729-1565
(800) 642-5031
(909) 989-7633
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT-4792
CA
Other
Enumeration date
03/22/2012
Last updated
03/22/2012
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