| NPI | 1801968318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL FULTON Owner President 662-234-8559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2013-05-14 |