| NPI | 1801025572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA SEMMEL Owner 310-991-7751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: CA PT25373) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT25373) |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2019-09-13 |