| NPI | 1427701077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAJIE MA Owner 209-910-9123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 208VP0000X |
| Enumeration Date | 2022-02-02 |
| Last Update Date | 2025-11-06 |