| NPI | 1861919060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTOPHER WILLIAM GRUNEWALD Owner/Physical Therapist 225-202-6124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 07612) |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2017-09-08 |