| NPI | 1407361835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANELL WILSON Owner 540-327-3368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: MD 07244) |
| Enumeration Date | 2017-12-07 |
| Last Update Date | 2017-12-07 |