| NPI | 1114468873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RATREE LERTKITCHAROENPON President & COO 386-451-2185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: FL PT13789) |
| Enumeration Date | 2017-03-14 |
| Last Update Date | 2017-06-28 |