| NPI | 1114357340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORTNEY PRATT-MESNARD Director Of Administration 870-307-9453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MD 1622) |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2024-11-22 |