| NPI | 1093122970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY A DEAN Owner 904-377-1174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: GA PT 008718) |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation (Licence: GA OT004504) |
| Enumeration Date | 2014-07-12 |
| Last Update Date | 2014-12-01 |