| NPI | 1558513010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA G DIXON Executive Director 310-293-7335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 174400000X Specialist (Licence: CA PT6921) |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2019-06-17 |