| NPI | 1598998775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE NELSON Physical Therapist/Agent 417-844-0223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 107405) |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2013-03-04 |