| NPI | 1285469759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETHANY ESTELLE GRADERT President 415-654-5324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2024-09-04 |
| Last Update Date | 2025-02-01 |