| NPI | 1104166024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IMELDA D PALISOC Owner 915-873-1169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2013-03-01 |
| Last Update Date | 2025-03-11 |