| NPI | 1851019095 |
|---|---|
| Doing Business As | LEGACY PT |
| Entity Type | Organization |
| Authorized Contact | TRACEE LIANE PUGH Owner/Member Of The LLC 319-624-0014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2022-08-15 |
| Last Update Date | 2022-11-10 |