| NPI | 1841220670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN LEO HEMELT Owner 904-501-3044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT21456) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL OT11336) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2011-08-19 |