| NPI | 1629474713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI HAGOOD Physical Therapist 405-642-9469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MN 8645) |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation (Licence: MN 8645) |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2014-11-17 |