| NPI | 1407441025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELSEY VAGNONI Physical Therapist 302-345-7202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine |
| Enumeration Date | 2021-03-05 |
| Last Update Date | 2021-03-05 |