| NPI | 1619704509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON MATOS CEO, Physical Therapist 918-720-1757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2024-09-16 |
| Last Update Date | 2024-09-16 |