| NPI | 1811081268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAKE MCBRIDE Owner 870-425-5881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: AR PT1458) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-08-22 |