| NPI | 1760704126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE HAUPT Owner 757-639-3153 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: VA 2305003917) |
| Enumeration Date | 2010-02-25 |
| Last Update Date | 2010-02-25 |