| NPI | 1851824486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN D JONES Co Owner 239-440-1075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports |
| 2251X0800X Physical Therapist, Orthopedic | |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2017-04-11 |