| NPI | 1750712618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK A DODSON Manager 318-473-9556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2013-12-03 |
| Last Update Date | 2013-12-03 |