| NPI | 1881036697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL SANDBORN President 386-445-9444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: FL ME98460) |
| Enumeration Date | 2013-07-22 |
| Last Update Date | 2013-07-22 |