| NPI | 1194737270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESIREE DEANNE EDLUND Clinic Director 949-724-0011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC26277) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: CA PT28504) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2008-08-04 |