| NPI | 1033286588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAYTON M REDDEN Owner 731-512-0302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: TN 6671) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2017-02-10 |