| NPI | 1972977643 |
|---|---|
| Doing Business As | ACTIVE PHYSICAL MEDICINE |
| Entity Type | Organization |
| Authorized Contact | SABRINA RICE HANSON Office Manager 909-581-3051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA15220) |
| Enumeration Date | 2015-11-18 |
| Last Update Date | 2015-11-18 |