Individual
JUANA LOURDES PORRAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17930 HERCULES ST, HESPERIA, CA 92345-5454
(818) 818-4667
Mailing address
17930 HERCULES ST, HESPERIA, CA 92345-5454
(818) 818-4667
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
87454
CA
Other
Enumeration date
08/31/2021
Last updated
12/09/2022
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