| NPI | 1912351602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALVIN DALE GRIFFIN Owner/Operator 662-871-0549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225200000X Physical Therapy Assistant | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2016-04-19 |