| NPI | 1699281162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNA VAN DUSEN Owner 530-632-1280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: CA PT24994) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: CA PT293470) |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2017-12-20 |