| NPI | 1760148514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN BROUHARD President, Treasurer, Secretary 805-402-2949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic |
| Enumeration Date | 2021-11-16 |
| Last Update Date | 2021-11-16 |