| NPI | 1376131144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER CRAIG HUMPHREY Owner/ Physical Therapist 757-635-0372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2021-01-06 |
| Last Update Date | 2021-01-06 |