| NPI | 1841034410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCAS DECKARD Owner/Physical Therapist 270-670-4733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Enumeration Date | 2024-06-19 |
| Last Update Date | 2024-06-19 |