| NPI | 1063979243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY KELLER CEO 870-761-6680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2019-02-25 |
| Last Update Date | 2019-02-25 |