| NPI | 1962036210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAISSA JEWELL SMITH Occupational Therapist/Owner 606-584-9999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2020-09-30 |