| NPI | 1700075124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH JOHNSEN Owner 912-510-6104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2007-10-22 |