| NPI | 1124768866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM BOKKER Co Owner 479-200-6360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2022-03-30 |
| Last Update Date | 2022-04-06 |