| NPI | 1932376555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDITH LYNN Administrator 386-445-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL 1549) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 0010163) |
| 225100000X Physical Therapist (Licence: FL 4154) | |
| 235Z00000X Speech-Language Pathologist (Licence: FL SA6443) | |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2008-05-27 |