Individual
MS. KIMYA LASHONDA PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
16462 PINE WOOD ST, FONTANA, CA 92336-1466
(909) 833-1132
Mailing address
16462 PINE WOOD ST, FONTANA, CA 92336-1466
(951) 833-1132
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA6430
CA
Other
Enumeration date
11/27/2019
Last updated
11/27/2019
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