| NPI | 1861854812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE MARTIN NIELSEN Physical Therapist 757-578-2197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305204696) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2021-02-04 |