| NPI | 1861656035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI M ALLEN Owner 904-465-0178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA5457) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 19154) |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2024-08-09 |