| NPI | 1255850293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEIL MCKENNA President 760-909-2355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 25475) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 261QP2000X Clinic/Center, Physical Therapy (Licence: CA 25475) | |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2022-07-21 |