| NPI | 1669887410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA B RUSS Physical Therapist 479-250-4014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AR 2874) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2017-01-23 |