| NPI | 1083259139 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SPENCER ANDREW COLE Owner 269-377-5117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic |
| 2251S0007X Physical Therapist, Sports | |
| Enumeration Date | 2019-11-13 |
| Last Update Date | 2019-11-13 |