| NPI | 1962427757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOBBY ISMAIL President 209-604-0013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2025-04-08 |