NPI | 1619480811 |
---|---|
Entity Type | Organization |
Authorized Contact | RUSSELL SIMMERMAN Part Owner 910-297-9714 |
Organization Subpart ? | No |
Primary Taxonomy | 225100000X Physical Therapist |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2017-11-09 |
Last Update Date | 2017-11-09 |