| NPI | 1780381202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SPENCER ROSS PETETT Owner/Physical Therapist 270-407-3177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2023-02-15 |
| Last Update Date | 2023-02-15 |