| NPI | 1346964129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELYN REISER Owner 757-652-5275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2022-09-27 |
| Last Update Date | 2023-01-03 |