| NPI | 1124498464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEQUAI TERRY MCLENDON Administrator 757-615-2195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 0105006790) |
| Enumeration Date | 2015-09-29 |
| Last Update Date | 2015-09-29 |