| NPI | 1134761612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER KEITH WHITEMAN President 765-210-0794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2019-10-16 |
| Last Update Date | 2019-10-16 |