| NPI | 1902198765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN DEWITT President/Owner 831-475-2565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: CA 30137) |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2011-05-11 |