NPI | 1205017514 |
---|---|
Entity Type | Organization |
Authorized Contact | DEENA POLL GOODMAN Owner/P.T. 310-441-1102 |
Organization Subpart ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 18437) |
Additional Taxonomies | 174400000X Specialist (Licence: CA PT 18437) |
Enumeration Date | 2007-11-15 |
Last Update Date | 2016-09-14 |