| NPI | 1841073343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY VU MABRY Physical Therapist 502-830-9671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2023-08-17 |
| Last Update Date | 2023-08-17 |