| NPI | 1487186748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK EVERETT BOEHLER Physical Therapist 567-230-2158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH 015060) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2017-03-28 |