| NPI | 1194230888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER REYNOLDS President 251-767-2597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: MI 7101005105) |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2017-12-05 |