| NPI | 1932559861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON MARC MARCHETTI Director 469-307-5109 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX L7470) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2016-11-28 |