| NPI | 1417318064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE PHILOPENA Owner 757-286-0544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305005569) |
| Enumeration Date | 2016-03-10 |
| Last Update Date | 2016-03-10 |