| NPI | 1770675639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATHEW MOORE Owner 530-753-9011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 22276) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 6526) |
| 225100000X Physical Therapist (Licence: CA 30188) | |
| 225100000X Physical Therapist (Licence: CA 32377) | |
| 225100000X Physical Therapist (Licence: CA 27732) | |
| 2251P0200X Physical Therapist Pediatrics (Licence: CA PT 16894) | |
| 225XH1200X Occupational Therapist Hand (Licence: CA 1528) | |
| 225XP0200X Occupational Therapist Pediatrics (Licence: CA OT 8402) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2009-03-13 |