NPI | 1740174655 |
---|---|
Entity Type | Organization |
Authorized Contact | GINGER JOHNSON Credentialing 818-294-2657 |
Organization Subpart ? | Yes |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
Enumeration Date | 2025-06-05 |
Last Update Date | 2025-06-05 |