| NPI | 1942453105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HANZ K TABORA Physical Therapist 904-771-3679 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 22278) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 9594) |
| 225100000X Physical Therapist (Licence: FL 9674) | |
| Enumeration Date | 2008-10-31 |
| Last Update Date | 2023-10-27 |