| NPI | 1528373073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE CHINGOON TRISTRAM President 904-315-0667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT 17260) |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2014-07-02 |