| NPI | 1730418997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUSTIN ALLEN GENTRY Owner/Provider 520-745-0545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 449) |
| Enumeration Date | 2009-12-17 |
| Last Update Date | 2009-12-17 |