| NPI | 1477906055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TABATHA JONES Office Manager 800-521-8065 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305210019) |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2016-09-19 |