| NPI | 1083990188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN RICCHINI Executive Director 904-346-3465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2011-11-02 |
| Last Update Date | 2019-01-24 |