| NPI | 1063033785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA DAWN JOHNSON Executive Director/PT 501-519-0964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2020-05-04 |
| Last Update Date | 2020-05-04 |