NPI | 1215028618 |
---|---|
Entity Type | Organization |
Authorized Contact | LORRAIN MACKAY Owner 225-751-3696 |
Organization Subpart ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 00619) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 01455F) |
225100000X Physical Therapist (Licence: LA 00356) | |
225100000X Physical Therapist (Licence: LA 02040F) | |
Enumeration Date | 2006-09-28 |
Last Update Date | 2020-08-22 |