| NPI | 1972010908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW P DANNEKER Owner/Director 760-503-5455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy (Licence: CA 33987) |
| Enumeration Date | 2017-12-29 |
| Last Update Date | 2018-08-07 |