| NPI | 1801940218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON SCOTT FRASER Certified Athletic Trainer 916-683-2580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2022-07-21 |