| NPI | 1720370794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AGNES LUCAS VIGILIA-MARAYA Administrator/Owner/Practitioner 260-418-8051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: IN PT05002613A) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: IN PT05002613A) |
| Enumeration Date | 2011-05-10 |
| Last Update Date | 2011-05-10 |