| NPI | 1942580899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES MICHAEL ELLIS Owner 334-356-6453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH1388) |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2011-08-24 |