| NPI | 1104190347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NORMA LEE STOCKSTILL Office Manager 870-741-1206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2012-03-07 |