| NPI | 1619169661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MILES FRISVOLD Owner/Administrator 913-387-0679 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2008-04-18 |