| NPI | 1902227200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON MYERS Owner 270-824-9295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic |
| Enumeration Date | 2014-01-04 |
| Last Update Date | 2014-01-04 |