| NPI | 1114077666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT DANIEL SPARKS Owner 727-796-5478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2012-02-08 |