| NPI | 1477153674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDY REED Manager/Credentialing 661-335-7755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2020-10-27 |