Organization
WEST COAST SPINE AND SPORTS THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY D KISHINO OT (DIRECTOR)
(951) 653-4480
Entity
Organization
Contact information
Practice address
6814 MAGNOLIA AVE, RIVERSIDE, CA 92506-2843
(951) 774-0793
(951) 774-0783
Mailing address
6814 MAGNOLIA AVE, RIVERSIDE, CA 92506-2843
(951) 774-0793
(951) 774-0783
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Enumeration date
11/05/2010
Last updated
11/05/2010
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