| NPI | 1629193305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVRA BOMMARITO President 209-546-0944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: CA 15780) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2008-05-15 |