| NPI | 1902102023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK DECICCO Partner/Physical Therapist 714-858-4617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 33693) |
| Enumeration Date | 2011-02-08 |
| Last Update Date | 2015-02-26 |