| NPI | 1073164646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN VANATOR CFO 765-741-2891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine |
| Additional Taxonomies | 225100000X Physical Therapist |
| 2251P0200X Physical Therapist, Pediatrics | |
| 225X00000X Occupational Therapist | |
| 225XP0200X Occupational Therapist, Pediatrics | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2019-09-25 |