| NPI | 1104590389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NOEL SANTAYANA CEO 909-238-8069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225200000X Physical Therapy Assistant |
| Enumeration Date | 2021-08-02 |
| Last Update Date | 2021-10-04 |