| NPI | 1407449648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANJAY SURESH KAWANKAR CEO / CFO Practice Manager 323-727-2887 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2021-02-18 |
| Last Update Date | 2021-02-18 |