| NPI | 1881290468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL O BAUTISTA CEO 858-997-7638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2020-12-08 |
| Last Update Date | 2024-02-10 |