NPI | 1568756757 |
---|---|
Entity Type | Organization |
Authorized Contact | JACKIE B CANNON Owner, President 866-484-8183 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: PA PT003408L) |
Additional Taxonomies | 225100000X Physical Therapist |
261QM1300X Clinic/Center, Multi-Specialty (Licence: PA PT003408L) | |
Enumeration Date | 2011-06-05 |
Last Update Date | 2019-03-04 |