| NPI | 1396145850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON LEE GARDNER Physical Therapist/Owner 870-919-0274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AR PT 3047) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: AR OT 2329) |
| 235Z00000X Speech-Language Pathologist, (Licence: AR SP 2878) | |
| 235Z00000X Speech-Language Pathologist, (Licence: AR SP 1873) | |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2014-09-12 |