| NPI | 1174188411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY MARIE SANDERS President 805-788-0805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2020-12-11 |