| NPI | 1912386376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN DAIGLE Billing Manager 818-706-9435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2022-07-21 |