Individual
CIVILLANI DELA PENA LAYOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15362 GARFIELD DR, FONTANA, CA 92336-4015
(909) 574-6192
(909) 574-6192
Mailing address
15362 GARFIELD DR, FONTANA, CA 92336-4015
(909) 574-6192
(909) 574-6192
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
28911
CA
Other
Enumeration date
11/03/2010
Last updated
11/03/2010
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