| NPI | 1164994810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NOEL SANTAYANA Secretary 909-371-6083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225200000X Physical Therapy Assistant |
| Enumeration Date | 2018-12-19 |
| Last Update Date | 2020-02-18 |