| NPI | 1578880381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER NOEL HENDERSON Doctorate Of Physical Therapy 865-809-2483 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: KY 005482) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY PT005482) |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2010-10-20 |