| NPI | 1043564776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENITO CANTU GUERRA Authorized Official 989-401-2480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2012-11-02 |
| Last Update Date | 2012-11-02 |