| NPI | 1235845561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCE CAMERON COO 228-348-0694 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225200000X Physical Therapy Assistant |
| Enumeration Date | 2023-01-30 |
| Last Update Date | 2023-01-31 |