| NPI | 1548219447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY T JOHNSON Owner Member Physical Therapist 417-888-0808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO R1012) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2011-12-12 |