| NPI | 1124691464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN S. HORTON Director 386-446-9935 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine |
| Enumeration Date | 2021-07-23 |
| Last Update Date | 2024-11-01 |