| NPI | 1124373162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA NICOLE ATKINSON Insurance & Billing Coordinator 850-656-1837 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 6662) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2012-07-16 |