| NPI | 1699111617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYAM RAHIMI Medical Director / Physician 855-433-5633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation Sports Medicine |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2013-05-16 |