| NPI | 1255720900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY POBLETE Physical Therapist 339-970-8630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MA 18735) |
| Enumeration Date | 2015-01-19 |
| Last Update Date | 2015-01-19 |