| NPI | 1114116878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN MOODY Owner 870-932-5551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: AR 819) |
| Enumeration Date | 2007-10-18 |
| Last Update Date | 2007-10-18 |