| NPI | 1346668530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE GIBBONS Owner 2152-393-0697 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: PA MD 038770l) |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2014-04-03 |