NPI | 1538597646 |
---|---|
Entity Type | Organization |
Authorized Contact | CRYSTAL HENRY Managing Member 870-421-6937 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0400X Clinic/Center Rehabilitation (Licence: AR 1565) |
Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy (Licence: AR 1565) |
261QR0400X Clinic/Center Rehabilitation (Licence: AR OTR1340) | |
Enumeration Date | 2013-10-29 |
Last Update Date | 2025-06-13 |