| NPI | 1619172186 |
|---|---|
| Other Name | TIDEWATER REHAB |
| Entity Type | Organization |
| Authorized Contact | DAVID HARRIS Administrator 757-622-8181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2007-11-01 |