| NPI | 1043734221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN JOHANNESON Authorized Official 423-238-7217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2022-07-21 |