| NPI | 1023203825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMMY WAYNE LOCKHART President 772-778-2106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME90530) |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2008-02-21 |