| NPI | 1053305748 |
|---|---|
| Doing Business As | SOUTHERN THERAPY AND WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | AMANDA BENNETT Billing Agent 386-312-0022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Additional Taxonomies | 376J00000X Homemaker |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2010-08-12 |