| NPI | 1710384953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL DOMINGO Owner, CEO 352-613-4658 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation (Licence: WA PT60289375) |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2025-11-14 |