| NPI | 1386004927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK KEVIN HALL Owner 712-574-4410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: SD 1369) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: SD 0986) |
| Enumeration Date | 2016-02-24 |
| Last Update Date | 2016-06-01 |