| NPI | 1477003085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN G KELLING Owner 951-375-7972 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2016-10-06 |
| Last Update Date | 2018-02-09 |