| NPI | 1861057713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY KELLER CEO 870-761-6680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2019-05-07 |