| NPI | 1710560321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP DAVID TYRE Owner, CEO 302-648-5060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2021-05-01 |
| Last Update Date | 2024-05-09 |