| NPI | 1477744647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL DAVID GLASGOW Manager 804-314-8240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305006737) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: VA 0119002452) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2007-08-05 |