| NPI | 1245776590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARREN LOUIS NELSON Owner 262-551-7946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 11955-024) |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2017-01-10 |