| NPI | 1104213685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLAN E VALENZUELA President 423-240-0512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2021-05-24 |