| NPI | 1316323314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD TITUS GOODMAN Owner 256-348-2144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: AL PTH4539) |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2015-08-03 |