| NPI | 1184256646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN DUVALL President 870-204-5330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant |
| 225100000X Physical Therapist | |
| 225200000X Physical Therapy Assistant | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2020-02-12 |
| Last Update Date | 2020-02-12 |