| NPI | 1861208472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREVOR DAVIDSON Owner 479-364-0223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy |
| Enumeration Date | 2024-12-09 |
| Last Update Date | 2024-12-09 |