| NPI | 1477028702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYRENIA MAQUEIRA Owner 386-466-5625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2018-10-13 |
| Last Update Date | 2019-08-17 |