| NPI | 1356646632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELILA BEJERANO Administrative Officer 870-704-9800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2011-01-19 |
| Last Update Date | 2011-01-19 |