| NPI | 1649743329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAIGE WHITAKER OLIVER Owner/Otr/L 606-233-9240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2019-01-06 |
| Last Update Date | 2021-11-12 |