| NPI | 1114430071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY KYLE KINTZING CEO 318-828-1450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: LA 08117) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 08117) |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2020-07-15 |