| NPI | 1619324886 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN CHARLES ROY Exercise Therapist/ Owner 337-371-9312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2016-05-18 |