| NPI | 1497884399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA ANN NOHR Office Manager 386-252-7837 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: FL MM11301) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2020-08-22 |