| NPI | 1275298341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH ADELE DONOVAN Member 601-506-0411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251G0304X Physical Therapist Geriatrics |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2021-11-03 |
| Last Update Date | 2022-12-19 |