| NPI | 1518115070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIPHAPHONE SOPHABMYXAY Physical Therapist 267-251-1784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: PA PT016560) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: PA PT018640) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2009-05-07 |