| NPI | 1942609144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATRINA ALDRIDGE Owner 1662-336-1765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: TN 3265) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 224Z00000X Occupational Therapy Assistant | |
| 222Q00000X Developmental Therapist | |
| 252Y00000X Early Intervention Provider Agency | |
| 2251P0200X Physical Therapist, Pediatrics | |
| 225100000X Physical Therapist (Licence: TN 3911) | |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2014-10-30 |