| NPI | 1912364613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD ELLIOTT BAXTER President/Owner 267-235-8789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2016-01-26 |
| Last Update Date | 2018-08-09 |