| NPI | 1124276217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON YISU PARK CEO/ Owner 719-550-4613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2022-09-08 |