| NPI | 1770554990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRON TRACY SOUTH Physical Therapist / Owner 479-856-6571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2009-09-14 |