| NPI | 1861254278 |
|---|---|
| Former Legal Business Name | DUPONT WELLNESS GROUP, PLLC |
| Entity Type | Organization |
| Authorized Contact | COREY DUPONT Owner, Physical Therapist 208-570-3004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2024-01-30 |
| Last Update Date | 2024-04-26 |