| NPI | 1912570359 |
|---|---|
| Former Legal Business Name | ELIZABETH BRACKEN |
| Entity Type | Organization |
| Authorized Contact | ELIZABETH BRACKEN Owner 937-681-6676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2021-07-22 |
| Last Update Date | 2021-07-22 |