| NPI | 1346301751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON A GRAY Director 559-222-7497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 24892) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 34452) |
| 225100000X Physical Therapist (Licence: CA 22900) | |
| 225100000X Physical Therapist (Licence: CA 25847) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2010-10-22 |