| NPI | 1013151109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAYTON MICHAEL REDDEN President 731-512-0302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 6671) |
| Enumeration Date | 2009-04-21 |
| Last Update Date | 2016-06-07 |