| NPI | 1114256369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY CROSS Assistant Secretary 423-473-5867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center Rehabilitation (Licence: AZ OTC1471) |
| Enumeration Date | 2009-12-17 |
| Last Update Date | 2021-09-15 |