| NPI | 1609258128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERNANDO LUIS SOUTULLO President 626-566-8332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: CA 41255) |
| Enumeration Date | 2015-06-20 |
| Last Update Date | 2015-08-21 |