| NPI | 1891334835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HANNAH RICHESIN Pediatric Physical Therapist 870-715-5488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center Developmental Disabilities |
| Enumeration Date | 2019-12-21 |
| Last Update Date | 2019-12-21 |