Individual
BRICE PONTERI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5615 LAKE SHORE DR, SELMA, OR 97538-9711
(650) 440-0856
Mailing address
5615 LAKE SHORE DR, SELMA, OR 97538-9711
(650) 440-0856
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
OR
Other
Enumeration date
03/22/2022
Last updated
03/22/2022
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