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Individual

SEAN JERAL CHILDRESS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
14880 CENTRAL AVE, CHINO, CA 91710-9509
(909) 606-3237
(909) 606-3958
Mailing address
14880 CENTRAL AVE, CHINO, CA 91710-9509
(909) 606-3237
(909) 606-3958

Taxonomy

Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary

Other

Enumeration date
11/17/2006
Last updated
07/08/2007
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