| NPI | 1124671151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA ILES Owner, Physical Therapist 605-670-1985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2019-10-10 |