| NPI | 1679690655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE M. COOK Office Manager 850-763-0505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: FL HCC6299) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2020-08-22 |