| NPI | 1396712626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS R COOPER Owner 334-741-0336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: AL PTA1442) |
| Enumeration Date | 2006-03-06 |
| Last Update Date | 2020-08-22 |