| NPI | 1023443165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN M JENKINS President/Secretary 949-208-2639 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT24251) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 39476) |
| Enumeration Date | 2013-09-09 |
| Last Update Date | 2015-01-07 |