| NPI | 1699347872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEAIRRA GRIER Enrollment Coordinator 980-302-8357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2021-07-15 |
| Last Update Date | 2021-07-15 |