Most Relevant Information
Provider Data
| NPI Number: | 1003279266 |
| Provider Name: | VANESSA AVILA |
| Entity Type: | Individual |
| Taxonomy Code: | 225400000X |
| Specialty: | Rehabilitation Practitioner |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/04/2016 |
| Last Updated: | 04/04/2016 |
Provider Practice Location
108 W VICTORIA ST
GARDENA
CA
902483523
Practice Location Phone/Fax
| Phone: | 3107152020 |
| Fax: |
Provider Mailing Location
108 W VICTORIA ST
GARDENA
CA
902483523
Provider Mailing Phone/Fax
| Phone: | 3107152020 |
| Fax: |