| NPI | 1225433121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER SERGEANT HUNGATE Physical Therapist/Co Owner 331-215-4164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070013653) |
| Additional Taxonomies | 224Y00000X Clinical Exercise Physiologist |
| 225100000X Physical Therapist (Licence: IL 070013648) | |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2014-11-04 |