| NPI | 1396867966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA MOELLER Administrative Assistant 325-658-6571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 174400000X Specialist |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2020-08-22 |