| NPI | 1528524352 |
|---|---|
| Former Legal Business Name | SOMATIC PHYSICAL THERAPY |
| Entity Type | Organization |
| Authorized Contact | NICHOLAS J LONG Owner/Physical Therapist 920-940-8350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2019-02-18 |
| Last Update Date | 2019-02-18 |