| NPI | 1508052739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORY MICHAEL FABER CEO/President 605-339-1800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics (Licence: SD 0295) |
| Additional Taxonomies | 225XP0200X Occupational Therapist Pediatrics (Licence: SD 0522) |
| 235Z00000X Speech-Language Pathologist (Licence: SD 01100452) | |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2007-09-20 |