Physician Nutraceutical Research, INC
NPI #1154627925 in San Clemente, California
Provider Information
- NPI Number
- 1154627925
- Entity Type
- Organization
- Organization Name
- Physician Nutraceutical Research, INC
- Primary Specialty
- Substance Abuse Rehabilitation Facility
- Enumeration Date
- Jan 26, 2011
- Last Updated
- Jan 26, 2011
Practice Location
- Address
- 140 AVENIDA ALGODON
- Address 2
- #A, B & C
- City
- San Clemente
- State
- California
- ZIP Code
- 92672-4182
- Phone
- (888) 508-3371
Authorized Official
- Name
- WILLA ANN LILLY, D.O.
- Title
- EXECUTIVE DIRECTOR
- Phone
- (888) 508-3371
Specialties & Taxonomy Codes
| Specialty |
|---|
| Substance Abuse Rehabilitation Facility |
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