| NPI | 1013554849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA W LONGWORTH Authorized Official 972-987-4672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225700000X Massage Therapist |
| Enumeration Date | 2019-11-27 |
| Last Update Date | 2021-04-07 |