| NPI | 1801282652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEIRON HOLMES Owner 793-314-9891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: VA 2305205379) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2015-04-08 |