| NPI | 1750044574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINE GO Owner 925-344-3388 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2251S0007X Physical Therapist Sports |
| Additional Taxonomies | 225100000X Physical Therapist |
| 2251X0800X Physical Therapist Orthopedic | |
| Enumeration Date | 2021-10-19 |
| Last Update Date | 2022-03-28 |