| NPI | 1881682078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH HISAMOTO Practice Administrator 813-979-4819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2018-04-04 |