| NPI | 1265861884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON R FALVEY Sole Member 207-951-0704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: WY 1376) |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2013-11-04 |