| NPI | 1255503736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY MASAO NAKASONE Physical Therapist 505-454-0443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NM 1308) |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2013-06-05 |