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Individual

MR. SIR OLIVER RAFAEL HERNANDEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1840 S NELSON ST APT 72, WEST COVINA, CA 91792-1498
(909) 992-2496
Mailing address
1840 S NELSON ST APT 72, WEST COVINA, CA 91792-1498
(909) 992-2496

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
9092
CA

Other

Enumeration date
01/07/2015
Last updated
01/07/2015
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