| NPI | 1871755223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONNIE NORMAN Manager 870-336-0238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist |
| 225200000X Physical Therapy Assistant | |
| 225X00000X Occupational Therapist | |
| 224Z00000X Occupational Therapy Assistant | |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2023-10-31 |