| NPI | 1164907804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN CARLOS MIRT Office Manager 401-401-0159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2018-09-28 |
| Last Update Date | 2023-09-07 |