| NPI | 1679390884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD SANDERS Manager 870-565-9770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2024-09-20 |
| Last Update Date | 2024-10-11 |