| NPI | 1518054758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REIN VANDERVELDE Physical Therapist 904-751-6646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT5670) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2009-06-01 |