| NPI | 1235433731 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | XANDRA TIELMAN Speech Pathologist 916-772-2909  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: CA SLP9200)  | 
| Enumeration Date | 2010-12-27 | 
| Last Update Date | 2010-12-27 |