| NPI | 1619113677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN D. CARRICO Owner 310-540-9699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2008-12-22 |
| Last Update Date | 2008-12-22 |