| NPI | 1912190174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH P. STACK President 1800-362-0903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NC 8899) |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2009-10-19 |