| NPI | 1104630144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY RAY KENNEDY Physical Therapist 985-630-7912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2025-02-01 |
| Last Update Date | 2025-02-01 |