| NPI | 1134563273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORETO BAYANI President 765-453-8855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05004058A) |
| Additional Taxonomies | 2251S0007X Physical Therapist Sports (Licence: 05004050A) |
| 2251X0800X Physical Therapist Orthopedic (Licence: IN 05004058A) | |
| Enumeration Date | 2013-04-19 |
| Last Update Date | 2015-05-26 |