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1982771481
RUSTEM IXANOV
SANTA ROSA, CA
NPI
1982771481
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Other Name
ROUSTEM IXANOV
Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: CA PT 32358)
Enumeration Date
2006-11-29
Last Update Date
2021-11-16
Business Address
MR. RUSTEM IXANOV MS,PT
3550 ROUND BARN BLVD # 112
SANTA ROSA, CA 95403-1796
Phone number: 707-566-5488
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Mailing Address
MR. RUSTEM IXANOV MS,PT
3550 ROUND BARN BLVD # 112
SANTA ROSA, CA 95403-1796
Phone number: 707-566-5488
Copy
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