| NPI | 1669554325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL WALTER Business Manager 760-567-7889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT8791) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2023-04-26 |