| NPI | 1063583516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAVI MCLEOD VP 772-696-4883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT0016300) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL OT9096) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2012-05-30 |