| NPI | 1164292082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLINTON WAYNE SERAFINO Owner 574-309-1427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation Sports Medicine |
| 2251S0007X Physical Therapist Sports | |
| 2251X0800X Physical Therapist Orthopedic | |
| 225200000X Physical Therapy Assistant | |
| 225XH1200X Occupational Therapist Hand | |
| Enumeration Date | 2024-01-02 |
| Last Update Date | 2024-01-02 |