| NPI | 1699045062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD KEITH WILSON President 772-299-3383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT2969) |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2012-01-03 |