| NPI | 1306867890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN J SANDBERG Officer 915-598-8120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX H6574) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2018-09-10 |