| NPI | 1831316041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA WHEATON Office Manager 949-709-8770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT24615) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-22 |