| NPI | 1629350137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN P WHELTON Owner 813-948-1020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: FL PT22249) |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2018-07-12 |