| NPI | 1740453455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY RAE BORDEAUX Physical Therapist Assistant 386-532-5003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: FL PTA18487) |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2008-04-03 |