| NPI | 1851501373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA JEAN BOUTELLE Owner 760-591-7750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251H1200X Physical Therapist, Hand |
| 225XH1200X Occupational Therapist, Hand | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2022-03-03 |