| NPI | 1831616416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT GRAY Owner/Founder 239-223-0484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT30740) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: FL 30740) |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2024-06-12 |