| NPI | 1386964773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY RANDLE COLES Physical Therapist 267-475-2458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT015725) |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2014-02-27 |