| NPI | 1568029148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS G. JOHNSTON President 660-676-8187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2024-09-09 |