| NPI | 1548251747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | J. TERRY DOOLING Member 618-465-7717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics |
| 225200000X Physical Therapy Assistant | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2020-08-22 |