| NPI | 1922296045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY D. BRIAND Owner 877-552-2996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 3939-024) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 37-039) |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2010-04-27 |