| NPI | 1639956246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY CHASE Co Owner 270-971-4344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2023-09-08 |
| Last Update Date | 2023-11-30 |