| NPI | 1184760498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOITUMELO P KGOADI Physical Therapist 337-857-6178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: LA 01833f) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2008-05-02 |