| NPI | 1588800874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES A PRUSSACK President, Owner 760-271-3850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2020-07-15 |