| NPI | 1235196783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE WATTLE Medical Billing Rep 209-575-4575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT6562) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA OT7355) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2020-08-22 |