| NPI | 1366824047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSANN MARIE MONTGOMERY Physical Therapist 918-540-7736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2015-06-18 |