| NPI | 1447647425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES DALE COOPER Administrator 727-240-1017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 111N00000X Chiropractor |
| 207QA0505X Family Medicine, Adult Medicine | |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2015-04-17 |