| NPI | 1770228298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL BLACKBURN Owner 469-256-6661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2022-04-29 |
| Last Update Date | 2022-10-12 |