| 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 |