| NPI | 1184852493 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA KOTOLSKI Owner 727-637-6137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QR0400X Clinic/Center, Rehabilitation | |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2024-01-18 |