| NPI | 1922734482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH STOUT Partner 817-386-7865 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164X00000X Licensed Vocational Nurse |
| Additional Taxonomies | 225700000X Massage Therapist |
| Enumeration Date | 2022-07-27 |
| Last Update Date | 2022-07-27 |