NPI | 1265205736 |
---|---|
Entity Type | Organization |
Authorized Contact | TRACY MCCALL Credentialing 479-201-6091 |
Organization Subpart ? | No |
Primary Taxonomy | 225100000X Physical Therapist |
Additional Taxonomies | 225X00000X Occupational Therapist |
235Z00000X Speech-Language Pathologist | |
Enumeration Date | 2023-11-06 |
Last Update Date | 2023-11-06 |