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Contact Information

KEVIN J INNIS JR
1801 THIRD ST.
SUITE 101
NORCO, CA92860
 Phone: 951-777-2178
 Fax: 951-797-6855
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for KEVIN J INNIS JR · (Male)

NPI # 1205590312
Status Active
Credentials
Entity Individual
Enumeration date 10/25/2021
Last updated 10/25/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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