| NPI | 1669648481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA JEAN SMITH Owner Secretary 858-454-9355 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT13530) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT23105) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2008-05-01 |