| NPI | 1689405029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN FJELLSTROM Owner 209-581-7944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation |
| Enumeration Date | 2024-08-08 |
| Last Update Date | 2024-08-08 |