| NPI | 1588117519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAYLA DENISE PAUL Credentialing & Contract Manager 479-274-2004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AR MC-0254) |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2016-07-26 |