| NPI | 1871788489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY L GODDARD Owner 810-230-1030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2008-01-28 |