| NPI | 1396455515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRBY L BROOME Owner 864-275-0740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2022-11-29 |
| Last Update Date | 2024-01-25 |