Individual
MR. BERT ALLEN MAXWELL SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14660 OXNARD ST, VAN NUYS, CA 91411-3119
(818) 901-4836
Mailing address
14660 OXNARD ST, VAN NUYS, CA 91411-3119
(818) 901-4836
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
05/30/2013
Last updated
05/30/2013
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