| NPI | 1922789361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE M BUSTOS Physical Therapist 906-281-5544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2023-07-28 |
| Last Update Date | 2024-04-10 |