| NPI | 1881814671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA M DUPREE Office Manager 757-488-2864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2020-08-22 |