| NPI | 1538265152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINAMARIE SCHULTZ Business Manager 386-257-2672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2022-10-25 |