| NPI | 1114692597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMMANUEL FASANYA Owner/Founder 469-531-9697 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2021-08-09 |
| Last Update Date | 2021-08-18 |