| NPI | 1437825296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRISHA PHELPS Owner 270-685-9499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2021-08-20 |
| Last Update Date | 2022-05-11 |