| NPI | 1093103970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN SMITH CEO 704-496-0501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225800000X Recreation Therapist |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports |
| 251S00000X | |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2014-12-31 |
| Last Update Date | 2014-12-31 |