| NPI | 1235991787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON E BALLARD Managing Manager 210-364-3569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2024-01-29 |
| Last Update Date | 2024-01-29 |