| NPI | 1891746228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISMAILU O AGBAJE Owner 812-272-4497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WV 23966) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2020-10-08 |