| NPI | 1578373189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN REAU COO 352-404-6908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2025-01-08 |
| Last Update Date | 2025-01-08 |