| NPI | 1669571188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY K MULLNIX Practice Administrator 707-303-4995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT11380) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-04-14 |