| NPI | 1912108572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC LARSON Owner 949-595-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: CA PT33089) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: CA PT24951) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2008-02-13 |