NPI | 1013461755 |
---|---|
Entity Type | Organization |
Authorized Contact | CEDRIC KENNARD DONALDSON Owner 601-918-6980 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: AL PTH6362) |
Enumeration Date | 2016-08-11 |
Last Update Date | 2016-08-11 |