| NPI | 1649853094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER MARTIN Co Owner 757-894-3801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2021-05-04 |