| NPI | 1174199988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID JOSEPH SCHWANEBECK President 662-803-5799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2021-07-21 |