| NPI | 1689079709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN M. VAN NOSTRAND President 941-205-2180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2014-10-31 |
| Last Update Date | 2014-10-31 |