| NPI | 1497523229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN KAY Administrator 866-439-3165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2023-12-12 |
| Last Update Date | 2024-02-27 |