| NPI | 1275936999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL L JACKSON Provider/Owner 270-559-7107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XN1300X Occupational Therapist, Neurorehabilitation (Licence: MO 2007016126) |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2021-03-10 |