NPI | 1700850401 |
---|---|
Entity Type | Organization |
Authorized Contact | WILVAN MATTHEW MILLER Owner 318-487-0211 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: LA 368814) |
Enumeration Date | 2006-02-17 |
Last Update Date | 2014-07-16 |