| NPI | 1467561670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL LEE STEWART Owner/PT 662-284-4656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS 5927860001) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2008-04-20 |