| NPI | 1225061542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY RANDALL Director/Owner 606-679-1761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 225400000X Rehabilitation Practitioner | |
| 225XP0019X Occupational Therapist, Physical Rehabilitation | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2016-03-01 |