Provider First Line Business Practice Location Address:
13542 SECOND STREET
Provider Second Line Business Practice Location Address:
REHAB ROOM
Provider Business Practice Location Address City Name:
YUCAIPA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92399-5396
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-904-9048
Provider Business Practice Location Address Fax Number:
323-900-0285
Provider Enumeration Date:
07/27/2026