Individual
BISI N WILTON WADDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7247 TAGGART PL, RANCHO CUCAMONGA, CA 91739-1868
(310) 493-1356
Mailing address
7247 TAGGART PL, RANCHO CUCAMONGA, CA 91739-1868
(310) 493-1356
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
26266
CA
Other
Enumeration date
04/30/2026
Last updated
04/30/2026
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