| NPI | 1497053318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLETTE M. COINER Authorized Official 888-713-2220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA pt17119) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: CA pt17119) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: CA pt17119) | |
| Enumeration Date | 2011-03-01 |
| Last Update Date | 2022-08-15 |