| NPI | 1790743003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARITA R MOORE Credentialing And Provider Services 951-696-9353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225700000X Massage Therapist |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2018-08-07 |