| NPI | 1801175377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN KEIKO RAVENELLE CFO 626-441-3124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT 14400) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: CA AT644) |
| Enumeration Date | 2011-08-15 |
| Last Update Date | 2011-08-15 |