| NPI | 1609857945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN JOY GLIDEWELL Owner/Administrator 916-934-0914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2005-11-11 |
| Last Update Date | 2018-01-22 |