| NPI | 1952394603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGEL COLLADO Credentialing Officer 858-264-1417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2005-08-29 |
| Last Update Date | 2024-08-29 |