SHANE RAVENELLE

LAKE FOREST, CA
NPI1780229898
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: CA  297650)
Enumeration Date2019-11-12
Last Update Date2019-11-12
Business Address
SHANE RAVENELLE PT, DPT
24301 MUIRLANDS BLVD STE T
LAKE FOREST, CA 92630-3627
Phone number: 949-271-0012
Mailing Address
SHANE RAVENELLE PT, DPT
3230 E IMPERIAL HWY STE 100
BREA, CA 92821-6735
Phone number: 714-988-8110