| NPI | 1770628141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIAN CRAIG MCCULLOCH Owner 225-775-7051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: LA PT-0307) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2018-06-21 |