| NPI | 1083759021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY PASOL Otr 907-334-9002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2020-08-22 |