| NPI | 1336409085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNAH HUONG LE Office Manager 408-440-2359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist Sports |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225200000X Physical Therapy Assistant | |
| 2255A2300X Specialist/Technologist Athletic Trainer | |
| 363AM0700X Physician Assistant Medical | |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2012-10-09 |