| NPI | 1124880240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISSY BOOHER Owner 571-212-6145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2024-01-24 |
| Last Update Date | 2026-01-09 |