| NPI | 1881655298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMMY DIRE MATHENA President 434-836-4158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 23005523) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: VA 0119003075) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2013-06-13 |