Individual
MR. CORNELL ALLEN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
89 PALM DR, CAMARILLO, CA 93010-7963
(805) 236-7807
Mailing address
PO BOX 483, PORT HUENEME, CA 93044-0483
(805) 236-7807
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
09187
CA
Other
Enumeration date
03/28/2012
Last updated
03/28/2012
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