Individual
MICHELLE RICO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
6288 GOLDEN TRAILS AVE, RANCHO CUCAMONGA, CA 91739-9109
(909) 463-4114
(909) 463-9664
Mailing address
6288 GOLDEN TRAILS AVE, RANCHO CUCAMONGA, CA 91739-9109
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
02/14/2006
Last updated
07/08/2007
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