| NPI | 1629336235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PENNY WILSON Manager 951-788-6115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225700000X Massage Therapist |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2012-05-02 |