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1063145399
ELLIS ODA
RIVERSIDE, CA
NPI
1063145399
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: CA 302036)
Enumeration Date
2022-07-05
Last Update Date
2022-07-05
Business Address
ELLIS ODA DPT
6177 RIVER CREST DR STE A
RIVERSIDE, CA 92507-0728
Phone number: 951-653-4480
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Mailing Address
ELLIS ODA DPT
6177 RIVER CREST DR STE A
RIVERSIDE, CA 92507-0728
Phone number: 951-653-4480
Copy
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