| NPI | 1124456868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN WILSON President 858-752-8423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: CA PT 33609) |
| Enumeration Date | 2013-10-16 |
| Last Update Date | 2020-01-15 |