| NPI | 1831829670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN LASCALA General Manager 424-269-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2022-06-14 |
| Last Update Date | 2022-06-14 |