| NPI | 1902075914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE VALLONE SHIMKO Owner/President 904-269-7751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT0014414) |
| Enumeration Date | 2008-02-23 |
| Last Update Date | 2011-10-05 |