| NPI | 1043084635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN LEA HARRIS CEO 916-693-1837 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2023-11-14 |
| Last Update Date | 2025-08-18 |