| NPI | 1811541691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY WEIL President & Director 502-262-6810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2023-12-06 |