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Individual

MR. RANDALL JAEGER WORTHINGTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CMT

Contact information

Practice address
6422 MAGNOLIA AVE, RIVERSIDE, CA 92506-2408
(951) 581-3242
Mailing address
6422 MAGNOLIA AVE, RIVERSIDE, CA 92506-2408
(951) 581-3242

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
34725
CA

Other

Enumeration date
06/22/2012
Last updated
06/22/2012
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