| NPI | 1225514110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN KOSTKA Co Owner,Doctor Of Physical Therapy 423-842-9322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2018-07-14 |
| Last Update Date | 2018-07-14 |