| NPI | 1083623284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS LEE ELLEXSON Owner 540-444-0291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 230500588) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2014-12-02 |