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NEWPORT BEACH, CA
NPI1396278545
Entity TypeOrganization
Authorized ContactBRANDON DEDERICH
Owner, Physical Therapist
949-261-6101
Organization Subpart ?No
Primary Taxonomy225100000X Physical Therapist
Enumeration Date2017-04-05
Last Update Date2017-04-05
Business Address
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2290 SE BRISTOL ST
NEWPORT BEACH, CA 92660-0746
Phone number: 949-261-6101
Mailing Address
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2290 SE BRISTOL ST
NEWPORT BEACH, CA 92660-0746
Phone number: 949-261-6101