| NPI | 1003215617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY L KELLER Occupational Therapist 661-714-1455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA 10496) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: CA 10496) |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2014-08-19 |