| NPI | 1710521414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE MIDTLYNG Owner 925-719-1516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 261QH0700X Clinic/Center, Hearing and Speech |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 261QX0100X Clinic/Center, Occupational Medicine | |
| Enumeration Date | 2019-11-05 |
| Last Update Date | 2019-11-05 |