| NPI | 1255744454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHY RUSSELL Sole Proprietor 928-853-9843 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 261QH0700X Clinic/Center, Hearing and Speech |
| 261QX0100X Clinic/Center, Occupational Medicine | |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2014-06-04 |