| NPI | 1730804642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD GRACIANO Patient Service Center Manager 915-261-9418 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2022-10-04 |
| Last Update Date | 2023-01-20 |