| NPI | 1861964231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW DOUGLAS PEACOCK Owner 254-582-2713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 261QH0700X Clinic/Center, Hearing and Speech |
| 261QX0100X Clinic/Center, Occupational Medicine | |
| Enumeration Date | 2018-12-26 |
| Last Update Date | 2023-09-29 |