| NPI | 1477197523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | D RUSSELL MOSHER Owner 757-539-2244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2019-11-01 |
| Last Update Date | 2020-02-10 |