| NPI | 1407302045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMMY L. JEFFERSON Athletic Trainer 954-632-9809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 273Y00000X Rehabilitation Unit (Licence: FL AL 638) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |