| NPI | 1003823709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN OLSON Owner 904-829-3411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: FL 18156) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2025-07-25 |