| NPI | 1518911312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MARK HEAP Owner 985-340-0102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: LA 1051) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2011-05-10 |