| NPI | 1730855016 |
|---|---|
| Doing Business As | BLACKWATCH PERFORMANCE AND THERAPY |
| Entity Type | Organization |
| Authorized Contact | SHELLEY ANNE ANDERSON Physical Therapist 229-402-3338 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2021-08-18 |
| Last Update Date | 2021-08-18 |