| NPI | 1427191543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGIA RUTH MOORE Office Manager 479-464-9672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AR 711022009) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2020-08-22 |