| NPI | 1164879433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERITA WILSON Physical Therapist 757-685-5016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305206223) |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2016-07-08 |