Kevin J Innis JR.

NPI #1205590312 in Norco, California

Provider Information

NPI Number: 1205590312
Entity Type: Individual
Name: Kevin J Innis JR.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Enumeration Date: Oct 25, 2021
Last Updated: Oct 25, 2021

Practice Location

Address: 1801 THIRD ST.
Address 2: SUITE 101
City: Norco
State: California
ZIP Code: 92860
Phone: (951) 777-2178

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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