| NPI | 1891312450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAKE RAPIER Executive Directer/Owner 385-306-1222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2020-06-30 |