| NPI | 1285104828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANCE D DOEBLE Ambr 941-888-4561 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2018-11-27 |
| Last Update Date | 2020-07-28 |