| NPI | 1356469514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERT B BOLDT Authorized Official/Owner 850-519-4966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225700000X Massage Therapist |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2024-01-03 |