| NPI | 1427325109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEN A HALVORSON Medical Director 877-408-2488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA G75477) |
| Enumeration Date | 2011-11-22 |
| Last Update Date | 2012-03-27 |