| NPI | 1194312538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANY REVELL Authorized Official/Partner/Owner 760-331-8111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2020-12-30 |
| Last Update Date | 2020-12-30 |