| NPI | 1396897930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROOKE RUNYAN CRAINE Owner 870-336-0021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics (Licence: AR PT2307) |
| Additional Taxonomies | 225XP0200X Occupational Therapist Pediatrics (Licence: AR OTR1655) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-08-22 |