| NPI | 1093227167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA MARSHALL PT 248-376-1781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: CO PTL.0013737) |
| Enumeration Date | 2017-10-30 |
| Last Update Date | 2017-10-30 |