| NPI | 1639574189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM SCOTT IANNAZZO Principal Member 619-363-2324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: CA 28858) |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2025-02-27 |