| NPI | 1891182598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA R BUTLER CEO 800-680-4039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| 261QR0400X Clinic/Center, Rehabilitation | |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2015-04-20 |