| NPI | 1750350476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF BLAKE Owner 310-392-7889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CA PT17676) |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2017-12-04 |