| NPI | 1912478728 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN KRUEGER Manager 850-380-4657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2018-12-06 |
| Last Update Date | 2018-12-06 |