Individual
MS. DORI MAXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
5830 SACRAMENTO AVE, RICHMOND, CA 94804-5610
(510) 527-0446
Mailing address
5830 SACRAMENTO AVE, RICHMOND, CA 94804-5610
(510) 851-1534
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
17253
CA
Other
Enumeration date
10/12/2009
Last updated
10/12/2009
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