| NPI | 1104922475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA SHIREY Credentialing COO Rdinator 318-504-4316 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2025-03-11 |