| NPI | 1548994866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW JIN Manager 833-988-0589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208VP0000X Pain Medicine, Pain Medicine | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2022-07-12 |