| NPI | 1366868432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY INGRAM-MITCHELL President 904-635-4638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2014-03-12 |
| Last Update Date | 2014-03-12 |