| NPI | 1326426644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHAN TUCKER Chief Executive Officer 310-321-4967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 103TE1100X Psychologist, Exercise & Sports |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2018-10-27 |