| NPI | 1225551443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY ALEXANDER HICKS Sports Rehabilitation Therapist 619-519-3632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 251E00000X Home Health |
| 253Z00000X In Home Supportive Care | |
| 261QR0800X Clinic/Center, Recovery Care | |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2019-11-12 |