| NPI | 1629914106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIANA ELISE MACKENZIE Physical Therapist 310-895-4518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic |
| Enumeration Date | 2026-04-27 |
| Last Update Date | 2026-05-04 |