Organization
MYOFASCIAL RESTORATION AND INTEGRATION POMC
Active
Other names
Myofascial Restoration and Integration
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD T VERCELES DO (OWNER, AUTHORIZED OFFICIAL)
(925) 326-8471
Entity
Organization
Contact information
Practice address
411 30TH ST STE 314, OAKLAND, CA 94609-3312
(925) 326-8471
Mailing address
155 SAINT GERMAIN LN, PLEASANT HILL, CA 94523-1135
(925) 326-8471
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
05/24/2021
Last updated
06/08/2021
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