Individual
TANNER RAVIZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1600 DOVE ST STE 100, NEWPORT BEACH, CA 92660-2438
(949) 502-3388
(949) 502-3304
Mailing address
1600 DOVE ST STE 100, NEWPORT BEACH, CA 92660-2438
(949) 502-3388
(949) 502-3304
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
304837
CA
Other
Enumeration date
01/03/2024
Last updated
01/03/2024
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