| NPI | 1871878041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY BOGART Credentialing Specialist 800-294-7001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CA 25614) |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2011-10-19 |