| NPI | 1154132090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ANTHONY PALACIOS CEO 909-802-5824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| 225200000X Physical Therapy Assistant | |
| Enumeration Date | 2025-01-20 |
| Last Update Date | 2025-09-29 |