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 |