| NPI | 1003637190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHANIEL HARRIS Owner And Physician 606-465-9597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2024-10-21 |
| Last Update Date | 2025-02-12 |