| NPI | 1952669335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN JON GWALTNEY Owner/Physical Therapist 401-596-1616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: RI 01993) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2012-04-24 |