| NPI | 1043296510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON D HAZELETT President 260-497-7191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2023-06-07 |