| NPI | 1295508679 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | SHONTRELL WATT Occupational Therapist 901-921-4997  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 225XP0019X Occupational Therapist, Physical Rehabilitation | 
| Enumeration Date | 2023-11-06 | 
| Last Update Date | 2023-11-06 |