| NPI | 1144624560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAN XI Owner 717-875-8909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD431974) |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2014-10-14 |