| NPI | 1689411399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYANNE BOLDUC Director Of Billing 941-460-3831 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2024-07-10 |
| Last Update Date | 2024-07-10 |