| NPI | 1205115144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD PANCHO GAJO Owner / Operator 407-608-9189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2011-08-10 |
| Last Update Date | 2011-08-10 |