| NPI | 1669102885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANIE DASRATH Occupational & Massage Therapist 386-965-3036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 261Q00000X |
| 261QH0100X Clinic/Center, Health Services | |
| Enumeration Date | 2022-06-11 |
| Last Update Date | 2022-08-30 |