| NPI | 1508687039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN FREDRIC KOELLING Physical Therapist 925-918-0090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Enumeration Date | 2024-10-17 |
| Last Update Date | 2024-10-17 |