| NPI | 1548302953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN DIANE MIZE Owner 757-641-0545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: VA 2305002648) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2020-08-22 |