| NPI | 1316974181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY ROYAL METHVIN Owner/Partner 760-946-2165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT12940) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2008-07-11 |