| NPI | 1376628131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED THURMOND Administrator 318-443-9305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant |
| 225200000X Physical Therapy Assistant | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2011-10-06 |