| NPI | 1881759686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW THOMAS CAPO President 228-463-9030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT1744) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2010-12-29 |