| NPI | 1083793707 |
|---|---|
| Doing Business As | PARK AVENUE PHYSICAL THERAPY |
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER NICOLAS DI REDO Physical Therapist / Owner 209-723-8144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: CA 0PT299911) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2008-06-19 |