| NPI | 1265565162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTY LINDSTROM Spa Director 209-571-1992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: CA PA13793) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2020-08-22 |