| NPI | 1891461745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAEYONG KIM Owner 909-815-1269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 171100000X Acupuncturist |
| Enumeration Date | 2021-08-20 |
| Last Update Date | 2021-08-20 |