| NPI | 1154192474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAVYA REDDY PUNURU Managing Member 619-203-9674 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2024-01-15 |
| Last Update Date | 2024-01-15 |