| NPI | 1104220680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL MAZAK Owner 419-961-6865 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2014-10-13 |
| Last Update Date | 2024-03-12 |