| NPI | 1861630378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER WAYNE FEARON President 904-891-0782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT21735) |
| Enumeration Date | 2009-01-22 |
| Last Update Date | 2009-01-22 |