| NPI | 1205383361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE S LEWIS Owner/Operator 863-644-7938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center Rehabilitation (Licence: FL MA68362) |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2016-09-07 |