Individual
JUSTIN CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
255 E RINCON ST STE 112, CORONA, CA 92879-1375
(951) 523-8509
Mailing address
1656 MESERVE ST, POMONA, CA 91766-2525
(951) 481-3043
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
51003
CA
Other
Enumeration date
01/26/2023
Last updated
01/26/2023
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