| NPI | 1073796462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLE MICHELLE CHENNAULT Owner/President 559-585-8087 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2007-12-10 |
| Last Update Date | 2007-12-10 |