| NPI | 1891257739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN BASS Co Owner 352-631-8568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2019-04-01 |