| NPI | 1578654927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY SUSANNE STEVENS President 765-654-9177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: IN 05002694A) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2020-08-22 |