| NPI | 1407293640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLIE J PEDEN Owner 877-864-8171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2013-06-03 |