| NPI | 1790890937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIESL LYNN OLSON Owner 806-792-5522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 653130000) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 555010000) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2014-09-23 |