| NPI | 1114070935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID JOE DURHAM President 804-843-9033 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305204769) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2007-12-07 |