| NPI | 1942023320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELSEY MCNUTT Provider Credentialing 256-350-1764 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2024-11-05 |
| Last Update Date | 2024-11-05 |