| NPI | 1619249406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS MIDDLETON Administrator 904-217-7648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 227900000X Respiratory Therapist, Registered | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2012-02-09 |