| NPI | 1710039664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE F. FAIN Administrator 276-694-8678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA H1919) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2008-04-20 |