| NPI | 1598467979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY J FOUNTAINE Owner, Lead Therapist 813-872-5747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2023-03-20 |