| NPI | 1639410384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEOFFREY GRAEME ANGELL Manager 904-891-1179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT 21700) |
| Enumeration Date | 2013-03-05 |
| Last Update Date | 2014-07-21 |