Individual
BRIAN EDWARD PONSNESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.A
Contact information
Practice address
427 WILSHIRE BLVD, SANTA MONICA, CA 90401-1409
(310) 656-8600
Mailing address
39 SUNSET AVE APT 205, VENICE, CA 90291-2545
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT9464
CA
Other
Enumeration date
04/13/2011
Last updated
04/13/2011
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