| NPI | 1508288804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC A COLCLASURE President 937-428-6273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: OH 012405) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: OH 07556) |
| Enumeration Date | 2014-01-06 |
| Last Update Date | 2014-01-06 |