| NPI | 1750068730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN LYLE ANDERSEN Co Owner 209-549-4626 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225XH1200X Occupational Therapist, Hand |
| Additional Taxonomies | 2251H1200X Physical Therapist, Hand |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2023-06-30 |
| Last Update Date | 2023-06-30 |