| NPI | 1407018476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS PATRICK FETTINGER Owner 940-996-1554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2008-06-30 |