| NPI | 1821417866 |
|---|---|
| Doing Business As | MODESTO PHYSICAL MEDICINE |
| Entity Type | Organization |
| Authorized Contact | JOHN BYSTROM Owner 209-838-3434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A74921) |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2023-01-11 |