| NPI | 1942625314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK HINES Owner/President 337-504-5144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 08100) |
| Enumeration Date | 2014-02-21 |
| Last Update Date | 2016-04-13 |