| NPI | 1750538336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK DANIEL VAN LOAN President 530-241-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy (Licence: CA PT26561) |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2021-08-04 |