| NPI | 1053823948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHANNA RUSSELL Physical Therapist / Owner 857-285-2955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MA 20730) |
| Enumeration Date | 2017-10-31 |
| Last Update Date | 2024-05-16 |