| NPI | 1043665748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM KELLEY Owner 850-461-0058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: FL PT7404) |
| Enumeration Date | 2016-04-30 |
| Last Update Date | 2016-04-30 |