| NPI | 1053561373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANA VAN SURKSUM Director 310-329-1444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2018-03-21 |