| NPI | 1700640901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLEISCHA OWEN Manager 407-312-4613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 111N00000X Chiropractor |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2024-02-08 |
| Last Update Date | 2024-06-18 |