| NPI | 1669506978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRAD HADA Partner/Therapist 580-327-3331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation Sports Medicine |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2019-07-02 |