| NPI | 1477966372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE SCAMMERHORN Occupational Therapist 731-707-1237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TN 4982) |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2014-06-09 |