| NPI | 1841324209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA D. MCBRYDE Owner 870-994-7778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2015-11-04 |