| NPI | 1538042437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BLAINE POTTS Managing Member 731-487-4770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2025-07-28 |
| Last Update Date | 2025-07-28 |