| NPI | 1932549888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLA SMILEY Credentialing Coordinator 888-590-4002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 653710004) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2019-08-20 |