| NPI | 1679828610 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | TARA NICOLE ATKINSON Insurance & Billing Coordinator 850-656-1837 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 6662) | 
| Enumeration Date | 2012-07-16 | 
| Last Update Date | 2012-07-16 |