| NPI | 1548343635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID C. BOUTELLE Owner/President 760-591-7750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 225XH1200X Occupational Therapist Hand | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2010-07-01 |