| NPI | 1821406661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON MILLER Director 254-630-1186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: TX 19405) |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2014-07-24 |