| NPI | 1679948368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSANNAH PARKE Physician/ B Usiness Owner 857-225-2664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI 5101018579) |
| Enumeration Date | 2015-12-07 |
| Last Update Date | 2020-06-02 |