| NPI | 1891093738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHEAL EUGENE BOGARD Owner 731-584-0942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: TN 2223) |
| Enumeration Date | 2011-03-02 |
| Last Update Date | 2011-03-02 |