| NPI | 1902161672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSANNE RUSSELL Owner 434-249-9578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: VA 2305003603) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2012-10-31 |