| NPI | 1346277316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE CAMPBELL DOUGLAS President 757-436-2695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305202603) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305005425) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2020-03-19 |