| NPI | 1619947678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDITH EASTERLY LOCKRIDGE Owner Physical Therapist 276-889-4090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: VA 2305002098) |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy (Licence: VA 2305002098) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2007-08-23 |