| NPI | 1871929729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA R KOPERNA Clinic Director 757-683-7041 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225200000X Physical Therapy Assistant |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2013-09-24 |
| Last Update Date | 2024-06-14 |