| NPI | 1225290745 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | HEATHER DAWSON Director Of Billing 765-446-5417 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist | 
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports | 
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2008-06-26 | 
| Last Update Date | 2024-10-18 |