| NPI | 1396268629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WARREN GREGORY HEBERT Registered Agent/Owner 310-903-1828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2017-07-18 |