| NPI | 1841247418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER LUY President 731-664-1172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: TN 261QP2000X) |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2020-08-22 |