Individual
VONTRAY LEWIS TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2736 SPRING ST, IMPERIAL, CA 92251-3015
(951) 775-0584
Mailing address
2736 SPRING ST, IMPERIAL, CA 92251-3015
(951) 775-0584
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
87283
CA
Other
Enumeration date
01/04/2022
Last updated
01/04/2022
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