| NPI | 1235643305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY MITCHELL Member 571-208-3099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: MD 17650) |
| Enumeration Date | 2017-11-27 |
| Last Update Date | 2020-04-10 |