| NPI | 1578962619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM M WALDEN Owner 606-515-1553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: KY PT003448) |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2014-08-14 |