| NPI | 1003569492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORY DOUGLAS DOMAYER CFO 386-231-3906 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0404X Clinic/Center Rehabilitation, Cardiac Facilities |
| Enumeration Date | 2022-01-27 |
| Last Update Date | 2024-02-15 |