| NPI | 1477851483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOGAN KAY BEASLEY Physical Therapist Assistant 731-225-7130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TN 4788) |
| Enumeration Date | 2011-03-01 |
| Last Update Date | 2011-03-01 |