Most Relevant Information
Provider Data
| NPI Number: | 1003371048 |
| Provider Name: | SHIRELY POBLETE GRAHAM PT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | PT30330 |
Most Important Dates
| Enumeration Date: | 02/04/2019 |
| Last Updated: | 02/04/2019 |
Provider Practice Location
1221 E ARROW HWY
UPLAND
CA
917864911
Practice Location Phone/Fax
| Phone: | 9099851903 |
| Fax: |
Provider Mailing Location
6563 BRISSAC PL
RANCHO CUCAMONGA
CA
917374348
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |