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General NPI Number Information
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NPI Number | 1841496155
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Entity Type | Organization
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Legal Business Name | AARN COMPANY
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Dates
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Enumeration Date | 06/23/2007
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Last Update Date | 08/21/2007
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Provider Practice Location Address
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Address Line | 2443 PAULINE ST
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City | WEST COVINA
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State | CA
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Zip | 91792-2613
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Country | US
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Telephone | 626-236-2302
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Fax |
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Provider Business Mailing Address
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Address Line | 2443 PAULINE ST
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City | WEST COVINA
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State | CA
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Zip | 91792-2613
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Country | US
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Telephone | 626-236-2302
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RICARDO R DACLISON
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Credential | RPT
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Telephone | 626-236-2302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT16434
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License Number State | CA
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