| NPI | 1780460667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRISTA WEIMER Owner/Manager/Physical Therapist 765-318-1841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2023-09-06 |
| Last Update Date | 2023-09-06 |