BRIAN A RAQUENO

ALTA LOMA, CA
NPI1548562523
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225100000X Physical Therapist
(Licence: CA  39061)
Additional Taxonomies225100000X Physical Therapist
(Licence: DE  J1-0002540)
Enumeration Date2010-11-24
Last Update Date2021-11-30
Business Address
BRIAN A RAQUENO PT, DPT
9850 19TH ST APT 186
ALTA LOMA, CA 91737-4232
Phone number: 302-345-2863
Mailing Address
BRIAN A RAQUENO PT, DPT
9850 19TH ST APT 186
ALTA LOMA, CA 91737-4232
Phone number: 302-345-2863