| NPI | 1760547467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA LYNN DOUGHERTY President, Clinical Director 310-721-2955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 24774) |
| Enumeration Date | 2006-12-25 |
| Last Update Date | 2020-08-22 |