| NPI | 1669493797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENTLY SHANE HOGAN Physical Therapist/ Owner 318-322-9980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 06610) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2007-11-28 |