| NPI | 1003636630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOGAN DOCKERY Owner/CEO 501-802-2844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2024-10-17 |
| Last Update Date | 2024-11-07 |