| NPI | 1639289077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY M PRESCOTT CFO 731-668-3322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics (Licence: TN PSS0000000110) |
| Additional Taxonomies | 225XP0200X Occupational Therapist Pediatrics (Licence: TN PSS0000000110) |
| 235Z00000X Speech-Language Pathologist (Licence: TN PSS0000000110) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |