| NPI | 1356885362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN HORNBUCKLE Owner 256-907-2493 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AL 186204) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: AL 31801) |
| Enumeration Date | 2016-12-09 |
| Last Update Date | 2018-05-31 |