| NPI | 1649669110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE L MCCLURE Physical Therapist 330-754-5628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy |
| Enumeration Date | 2015-01-21 |
| Last Update Date | 2019-01-03 |