| NPI | 1619503984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAITLYN RYAN Owner 570-470-6143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2020-03-19 |