| NPI | 1598861395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYANN THERESA DOMINGUEZ Practice Administrator 804-249-8277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2021-09-22 |