| NPI | 1124142799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD HAUPT Owner 941-955-1239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: FL 106621) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2015-04-10 |