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Individual

MR. EDWARD WILEY QUISENBERRY III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CMT

Contact information

Practice address
5206 BENITO ST STE 103, MONTCLAIR, CA 91763-2859
(909) 398-1092
(909) 621-9111
Mailing address
5206 BENITO ST STE 103, MONTCLAIR, CA 91763-2859
(909) 398-1092
(909) 621-9111

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary

Other

Enumeration date
05/22/2007
Last updated
07/08/2007
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