| NPI | 1992578223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN WELLER Owner 760-668-4172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| 261QM2500X Clinic/Center, Medical Specialty | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2023-10-30 |
| Last Update Date | 2025-06-21 |