| NPI | 1649223694 |
|---|---|
| Former Legal Business Name | PROSPORT PHYSICAL THERAPY INC |
| Entity Type | Organization |
| Authorized Contact | BOBBY ISMAIL President 209-353-1988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2023-12-06 |