| NPI | 1790924462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN J SUSAN Owner/Manager 386-668-1156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL PTA 15708) |
| Enumeration Date | 2009-02-19 |
| Last Update Date | 2009-03-17 |