| NPI | 1720320583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER WILSON Credentialing Manager 502-272-3463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2023-09-26 |