| NPI | 1083473383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ANDERSON President 855-380-6136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 2081N0008X Physical Medicine & Rehabilitation Neuromuscular Medicine |
| 261QC1500X Clinic/Center Community Health | |
| Enumeration Date | 2024-03-18 |
| Last Update Date | 2024-08-06 |