| NPI | 1457905234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW BENJAMIN MILHOLEN Manager 817-675-0782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2021-04-13 |