| NPI | 1275258485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY A MULLINS Biller/Credentialing Specialist 530-314-3971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2022-10-10 |
| Last Update Date | 2023-12-28 |