| NPI | 1598953960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENTON DAVID WYNN Owner /President Of Corporation 619-318-8233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A73257) |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2021-07-19 |