| NPI | 1598502361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KILEY S EVERSOLE Physical Therapist 269-615-0317 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2024-07-10 |
| Last Update Date | 2024-09-17 |