NPI | 1104108232 |
---|---|
Entity Type | Organization |
Authorized Contact | MAURICE D DAVIS President/CEO 612-327-5911 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: FL PT 24289) |
Enumeration Date | 2011-09-14 |
Last Update Date | 2017-11-10 |