| NPI | 1679781181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREVOR DAVID OXHOLM Manager 386-439-8433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT14652) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2009-07-29 |