| NPI | 1568202968 |
|---|---|
| Doing Business As | SOURCE PELVIC HEALTH |
| Entity Type | Organization |
| Authorized Contact | ELEONORA JOAN VINCE CEO 760-206-3076 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports |
| 2251X0800X Physical Therapist, Orthopedic | |
| Enumeration Date | 2024-05-31 |
| Last Update Date | 2024-05-31 |