| NPI | 1083430003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA SEBASTIAN GINGLES Owner/Operator 904-501-2626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2024-11-25 |
| Last Update Date | 2024-11-25 |