| NPI | 1265737548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELILA M BEJERANO Administrative Officer 870-704-9800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2011-01-19 |
| Last Update Date | 2011-01-19 |