| NPI | 1588772792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS ALFRED LAVAYEN Owner 949-367-1088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT11297) |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2007-09-28 |