Individual
ILIANA BRAVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
245 S LEMON ST APT D, ORANGE, CA 92866-1849
(714) 955-8549
Mailing address
13681 NEWPORT AVE # 8-915, TUSTIN, CA 92780-4689
(714) 955-8549
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5117
CA
Other
Enumeration date
08/15/2024
Last updated
08/15/2024
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