| NPI | 1013696848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAITLIN KENNEY Office Manager 870-450-2438 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225200000X Physical Therapy Assistant |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2023-07-18 |
| Last Update Date | 2023-07-18 |