| NPI | 1548592975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES MICHAEL POTTS Owner 318-324-0055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: LA MD016865) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2010-02-10 |
| Last Update Date | 2011-01-10 |