| NPI | 1366588444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHIL BOHART COO Wner 210-822-6323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 15980) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1038107) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-08-22 |