| NPI | 1184894735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLE RANDALL HUSSEY Owner 276-340-2204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: VA 2305003684) |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2017-02-21 |